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THE 



Practical Physician 



Home Apothecary, 

/ 

GEORGE HENCKEL 

WITH 

Medical Contributions By Eminent Physicians. 

EEVISED BY 



C. M. SPALDING, M. D 




.\\ 



*^ 



Entered according to the Act of Congress n the 
year 1891, by 

I. J. SMUCKEE, 

In the Office of the Librarian of Congress, 
at Washington, D. C. 



FRBFA.CB. 



Since the creation of man, there has been no subject that so 
immediately concerns the life and happiness of the individual, the love 
and harmony of friends and the prosperity of a country, as good health. 
The majority of mankind know less about themselves as far as their 
own body is concerned, than they do about their surroundings. When 
the house in which they live or the clothing they wear becomes out of 
order the father or mother, know, how to make amends. Have you, 
dear reader, ever thought how little you know about the abode, which 
your soul inhabits? No then when you are in health and do not 
know of the existence of the material body, you either do not take the 
time, or do not care what becomes of this body in which mind and 
matter so intimately commingle. But when you are afflicted with 
sickness, which always comes more or less unexpected, you are puz- 
zled and do not know what to do. Of course there are many people 
who have made a life study of the human body and the numerous dis- 
eases to which it is an heir. These doctor's, surgeons and specialists 
are all anxious for patients in their numerous lines and for their 
> attention to the sick, their fees are usually reasonable but occasionally 
their demands overreach the capacity of the pocketbook of the patient 
The object of this volume is that when sickness does appear that you 
"may have a counselor at hand and weapons to combat the approaching 
disease without incurring large doctor's bills. 

Out of the fullness of an observing earnest and truthful naure have 
come the words of instruction, of advice and of warning that go to 
make up the pleasant and inviting pages of this book, words and 
directions that apply to and concern every boy and girl, man or 
woman, married or single, who believe in keeping the body in a 
good, pure and healthy condition. 

It is your duty to acquaint yourself with the wonderful machinery 
of the body and when any part becomes out of order, you will know 
how to remedy the fault, providing you study carefully this book and 
learn the uses of the contents of the Home Apothecary. 

THE AUTHOR. 




Frontal. 
Parietal. 
Temporal. 
Cheek. 
Nasal. 

Upper Jaw. 
Lower Jaw. 
Neck Back 

bone joints (7.) 
Back Bone- 
Joints (12 



Loin Backbone Joints, 

Larcum. 

Coccyx. 

Ribs. 

Sternum or Breast. 

Collarbone or Clavicle. 

Shoulder blade, 

Humerus. 

Radius, 

Ulna. 

Carpus. 

Metacarpal. 

Finger Bones. 

renominate (Pelvis.) 

Femur. 

Kneepan. 

Fibia. 

Fibula. 

Bones of the feet. 



The Practical Physician 

OF THE HUMAN BODY. 

IN considering the ailments to which the human body is an heir 
it becomes apparent that a brief description must be given of 
it, especially for the enlightenment of those, who have not 
concentrated their mind, or even given a thought, upon the most per- 
fect of our Creator's handy work: 

THE HUMAN BODY. 

For every abode, whether we inhabit same, or our soul, we find 
that in its construction, a solid frame work exists, for the support, as 
in the human body, for the softer parts, as well as forming cavities 
requisite, for the proper protection of the vital organs. We find this 
frame work of our bodies in the various bones, composing what is 
commonly called 

THE SKELETON. 

The entire skeleton of an adult consists of 204 bones enumerated 
and classified on the illustration embodied in this treatise. 

Bone is one of hardest compositions in the body, but possesses to 
a certain degree, a toughress and elasticity. In examining it closer 
(by sawing the bone of any animal transversely) we find it to consist 
of two distinct tissues, one a hard mass, like ivory, the other consist- 
ing of slight fibres, which join irregular and form a sort of lattice 
work. The hard and compact tissue is always on the exterior, while 
the other forms the inside, acting as an additional brace, to with- 
stand strain, as well as being the repository for the marrow in the 
cavities formed by the fibrous tissues. 

All bones are covered by a tough membrane called the periosteum, 
which adheres to the surface in nearly every part, excepting at those 



2 SKELETON. 

places, where the cartilages and tendons are attached. This mem- 
brane is full of minute blood vessels, and it is thus that the bone re 
ceives its nourishment by the passing of these blood vessels into the 
small opening of each bone. 

The various bones in the human body are connected together at the 
different parts of their surface and such connections are termed the 
Joints. Some are movable, some are not, as for instance the bones of 
the face and skull. The greater number of joints are movable and 
are formed by the approximation of two long surfaces covered with 
cartilages, connected by ligaments, and lined by a membrane. The 
movements admissible in joints, in a healthy person, are almost in 
any direction. The ligaments, which so greatly assist in these move- 
ments, are of various forms to meet the emergency in the shape of 
the bone. They are pliant and flexible so as to allow the most per- 
fect freedom of movement, but strong, tough, and inextensile, so as 
not readily to yield under the most severely applied force, in conse- 
quence of which they are admirably adapted to serve as the connect- 
ing medium, or hinges between the bones, in movable joints. 

THE MUSCLES. 

The muscles are the active organs of locomotion. They are form- 
ed of reddish fibres and are endowed with the property of contractili- 
ty. Two kinds of muscular tissue are found in the animal body; 
namely, that of Voluntary or animal life, and that of Involuntary or 
organic life. 

The Voluntary Muscles are capable of being either exerted or con- 
troled by the efforts of the will. They are composed of bundles of 
fibres inclosed in a delicate web and each bundle consists of numer- 
ous smaller ones, also inclosed in a similar covering. 

The Involuntary Muscles or of organic life consist of flattened bands 
or of elongated, spindle shaped fibres, flattened, and are of a pale 
color. These muscles we find in the alimentary canal, forming the 
muscular coat of the digestive tube, from the middle of the gullet to 
the anus ; in the posterior wall of the bronchial tubes ; in the gall 
bladder and common bile duct, in the basin of the kidneys, in the 
ureters and bladder, and in the urethra. In the female it is met with 
in the vagina, uterus or womb, in the tubes and ligaments surrounding 
same; in the male we find these muscles in the scrotum, the semen 
carrying vessel, the semen vessel and prostrate gland. They are also 
found in both sexes in the caverous bodies ; in the coats of the arteries* 




THE MUSCULAR 
SYSTEM. 

1. Occipito-frontal. 

2. Temporal. 

3. Eyelid closing. 

4. Masseter. 

5. Sterno clydo-mas- 
toid. 

6. Trapezius or neck. 

7. Platysma myoides, 

8. Arm raising or deltoid 

9. Bending forearm. 

10. do do 

11. Straightening forearm. 

12. Flexor of the forearm. 

13. Extending thumb. 

14. do wrist. 

15. Breast. 

16. Back. 

17. Elevating shoulder. 

18. Oblique abdominal, 

19. Streight abdominal. 
20. Middle thigh. 

21. Great thigh. 

22. Turning limb inward 

23. Vastus external. 

24. Bending leg on thigh. 

25. Calf of leg. 



Bending foot. 
Extending toes. 
Soleus. 
) Act together in 
) drawing foot back. 
Flexoroffooton leg. 
Bends little toe 
Extends the great 

toe. 
Bends toes towards 

the sole. 
Tendo-Achilles, this 

is the strongest 

tendon in the 

body. 




MUSCLES. 3 

in most veins and lymphatic vessels; in the iris and ciliary muscles 
of the eye, and in the skin, as those which control the hair. 

Blood-vessels are distributed in considerable abundance in the 
muscles. In the voluntary muscles the capillaries, which are of ex- 
tremely minute size, form narrow oblong meshes, which run in the 
direction of the fibres. 

The Absorbing or Lymphatic Vessels in muscles are few in number 
aud appear to exist only in the larger muscles. 

The nerves of voluntary muscles are of large size. The larger 
branches pass between the bunches of the muscles, and, subdividing, 
unite to form primary communications, which are also called the plexus 
of the nerves; from these, finer bundles or single nerve tubes, pass be- 
tween the muscular fibres and forming loops return to the plexus. 

Each muscle is invested externally by a thin, cellular layer forming 
what is commonly called a sheath, or fascia, which covers the outer 
surface and serves as a bond of connection between them. 

The muscles are connected with the bones, cartilages, ligaments and 
skin, either directly or through the intervention of fibrous structures, 
called tendons. Where a muscle is attached to the bone or cartilage the 
fibres terminate in blunt extremities upon the periosteum or the mem- 
brane covering the latter and do not come in direct relation with the 
bony or cartilagenous substances. Where muscles are connected 
with the skin they either lie as a flattened layer beneath it or are con- 
nected with its tissue by larger or smaller bundles of fibres, as in the 
muscles of the face. 

The muscles vary considerably in form. In the limbs they are of 
considerable length, especially the superficial ones, the deep ones be- 
ing generally broad ; they surround the bones, and form an important 
protection to the joints. In the trunk they are flattened and expand- 
ed, forming the wall of the cavities which they inclose. 

Their sizes presents considerable variation; the Gastrocnemius 
forms the chief bulk of the back of the leg, and the fibres of the 
♦'Tailor's" muscle, which allows the position usually assumed by the 
tailors is nearly two feet in length, while the stirrup muscle of the 
internal ear, weighs only about one grain and its fibres are not more 
than two lines in length. In each case, however, they are admirably 
adapted to execute the various movements they are required to 
perform. 

The names of the muscles have been derived from various sources; 



4 ARTERIES. 

namely, from their situation; from their direction; from their uses^ 
from their shape ; from their number of divisions ; and from their 
points of attachment. 

For the names and location of the muscles, the reader is refered 
to the illustration of the muscular system of the human body, as well 
as organs intimately connected with the muscles. 

The tendons are connected on the one hand with the muscles ; and 
on the other with the bones, cartilages, ligaments, and membranes. 

THE ARTERIES. 

The arteries are cylindrical tubular vessels, which serves to convey 
blood from both ventricles of the heart to every part of the body. 
These vessels were named arteries (which means to contain air) from 
the belief entertained by the ancients that they contained air. This 
opinion has been, however, refuted long ago, inasmuch as it has been 
shown, that these vessels, though for the most part empty after death, 
contain blood in the living body. 

The pulmonary or lung artery, which arises from the right ventri- 
cle of the heart carries venous blood directly into the lnngs, from 
whence it is returned by the pulmonary or lung veins into the left 
auricle of the heart. This constitutes the lesser or pulmonary circu- 
lation. The great artery, the Aorta, which arises from tne left ven- 
tricle, conveys arterial blood to the body generally; from whence it is 
brought back to the right side of the heart by means of the veins. 
This constitutes the greater or systemic circulation. 

The distribution of the systemic arteries is like a highly ramified 
tree, the common trunk of which, formed by the aorta or great artery, 
commences at the left ventricle of the heart, the smallest ramifaca- 
tions corresponding to the circumference of the body and the contained 
organs. Arteries are found in nearly every part of our bodies, with 
the exceptions of the hair, nails, outer portion of skin, cartilages and 
the cornea; the larger arteries usually occupy the most protected 
situations, where they are less exposed to injury. 

The arteries in their distribution communicate freely with one 
another, forming what is called an anastomsis, or inosculation, and 
this communication is very freely between all branches. The inoscu- 
lation is especially found where great freedom and activity of the cir- 
culation is necessary, as in the brain ; in the abdomen, and in the 
limbs. These inosculations are of great interest to the surgeon as by 



CAPILLARIES. 5 

their enlargement, that a collateral circulation is established after the 
application of ligature to an artery, for the cure of widening and tu- 
mors in arteries. 

The smaller arteries inosculate more than the larger, and between 
the smallest twigs, these inoculations become so numerous as to con- 
stitute a close network, that prevades nearly every tissue of the body. 

The arteries are dense in structure, of considerable strength, highly 
elastic and when divided transversely, they preserve, although empty 
their cylindrical form. They have three coats, internal, middle and 
external. Arteries are also provided with blood vessels for their own 
nutriment, and nerves for the control of their actions. 

THE CAPILLARIES. 

The smaller arterial branches, with few exceptions, terminate in a 
network of vessels which prevade nearly every tissue of the body. 
These vessels from their minute size are termed capillaries (from 
capillus a hair). They are interposed between the smallest branches 
of the arteries and the commencing veins, constituting a network. 
The diameter of the capillaries varies in the different tissues of the 
body, their usual size being about 1-3C00 part of an inch. The smallest 
are those in the brain and the mucous membrane of the intestines ; 
the largest those of the skin, and the marrow of the bones. 

The form of the capillaries also varies and can be classified in 
rounded, elongated and looped meshes. 

THE VEINS. 

The veins are the vessels which serve to return the blood from the 
capillaries of the different parts of the body to the heart. They con- 
sist of two distinct sets of vessels, the pulmonary and systemic 

The Pulmonary Veins unlike other vessels of this kind, contain 
arterial blood, which they return from the lungs to the left auricle of 
the heart. 

The Systemic Veins, return the venous blood from the body gener- 
ally to the right auricle of the heart. 

The Portal Vein, an appendage to the systemic venous system is 
confined to the abdominal cavity, returning the blood from the diges- 
tive apparatus located in the abdomen and carrying it to the liver by a 
single trunk of large size, the portal vein. From the liver the blood 
is conveyed to the lower vena cava by means of the liver veins. 



6 VEINS. 

The veins, like the arteries, are found in nearly every tissue of the 
body; they commence by minute plexus, which communicate with the 
capillaries, the branches of which, uniting together, constitute the 
trunks, which increase in size, as they pass toward the heart, from 
the termination of larger branches in them. In form, the veins are 
not qu'te cylindrical, like the arteries, their walls being collapsed 
when empty. Veins are supplied with valves in their interior, for the 
apparent purpose to prevent the venous blood from retrograding to- 
ward the capillaries. The veins communicate very freely with one 
another, and this communication exists between the large trunks, as 
well as between the smaller branches. The walls of the veins are 
thinner than those of the arteries, which is due to the small amount 
of elastic tissue they contain. The veins nearest the surface, usually 
have thicker coats than the deep seated ones. Like arteries, they 
possess three coats, internal, middle and external. 

The veins are also supplied with nutrient blood vessels, like the 
arteries, but nerves, as a general thing are not found upon them. 

THE LYMPHATICS OR ABSORBENTS. 

The Lymphatics have derived their name from the appearance of 
the fluid contained in their interior (lympha water.) They are also 
called absorbents from the property they possess of absorbing certain 
materials for the replenishing of the blood, and conveying them into 
the circulation. 

The lymphatic system includes not only the lymphatic vessels and 
glands through which they pass, but also the lacteals or chyliferous 
vessels. The lacteals are the lymphatic vessels of the small intestines, 
and differ from the lymphatics generally, only, in that they contain a 
milk-white fluid, the chyle during the process of digestion, and con- 
tain is readily seen through them. They are found in nearly every 
texture and organ of the body, with the exception of the substance of 
the brain and spinal cord, the eyeball, cartilage, tendon, nails, cuticle, 
and hair. Their existence in the substance of the bone is doubtful. 

Like the arteries and veins they possess three coats. They have 
nutrient blood vessels in their outer and middle coat, but no nerves. 

The lymphatic or absorbent glands are small glandular bodies, sit- 
uated in the course of the lymphatic and lacteal vessels. 

All the lymphatic and lacteal vessels unite in one trunk, the 
thoracic duct, which conveys the great mass of lymph and chyle into 



LYMPHATICS. 7 

the blood. The thoracic duct commences in the abdomen by a tri- 
angular dilatation, the chyle recepracle and ascends behind the aorta, 
passing with it through the opening of the diaphragm, in front of the 
vertebral column. Opposite the fourth dorsal backbone joint it in- 
clines towards the left side of the gullet. Opposite the upper border 
of the seventh backbone joint it curves downward above the under 
shoulder artery, and terminates near the angle of the junction of the 
under shoulder vein and left jugular vein. At the commencement the 
thoracic duct is about the size of a goose quill, diminishes as it ascends 
to about the middle and then gradually distends towards its termina- 
tion. 

The carefully executed engraving, showing the formation and circu- 
lation of the blood in the arteries and veins, together with the lymph- 
atics, is especially referred to, for the situation and names of all the 
prominent blood vessels and absorbents in the human body. It was 
prepared especially for this work from recent dissections and the latest 
obtainable data, at much cost and labor by the author of this treatise. 
At a glance it is a complete object lesson, and gives a deep impress- 
ion on the mind of the most wonderful chemico-mechanical apparatus, 
which keeps body and soul united until death. 

This plate should also receive the earnest attention of the readers 
when studying the organs destined to accomplish the acts of life, 
usually called ■ 'functions." 

So far as practicable the names are in plain English, but the indulg- 
ence of the dear reader is asked for, when in the nomenclature a 
latin or so-called professional name has slipped in. It was neither 
accident nor mistake, but unavoidable. 

THE NERVOUS SYSTEM. 

It consists of a series of centres of nerve matter called collectively, 
the cerebro- spinal, or axis the ganglia, the nerves, which are 
either connected with the axis or ganglia, and the outside terminations 
of the nerves forming the organs of the external senses. 

The axis consists of two parts, namely, the spinal cord and the 
brain; the latter is usually subdivided into the cerebrum or brain 
proper; the cerebellum or small brain; the medulla oblongata, or 
upper bulbous expansion of the spinal cord; and the pons Varolii, 
which forms the connecting link between the first three mentioned 
subdivisions. 

The Spinal Cord is a cylindrical elongated part of the cerebro- 



8 NEKVOUS SYSTEM. 

spinal axis and is located in the hollow portion or canal of the back- 
bone joints and is about eighteen to nineteen inches in length. 

By making a transverse section of the spinal cord, it is found to 
consist of two nerve substances, the white and the gray. The former 
is the greater part and is situated externally. The latter or gray 
matter forms the internal part of the cord. The white substance of 
the spinal cord consists of nerve fibres, with blood-vessels. The gray 
matter consists of nerve fibres of various shapes and sizes, nerve cells 
and blood-vessels. 

From the spinal cord radiate (31) thirty-one pairs of spinal nerves 
divided as follows : 

Neck 8 pairs. 

Back 12 " 

Loin region 5 " 

Sacral region 5 " 

End of backbone, or Coccyx 1 " 

Each of these spinal nerves arises by two roots ; one a motor root 
and the other a sensory root. 

The Cerebrum or Large Brain is situated in the upper portion of 
the cranium, and subdivided into two halves or hemispheres, right 
and left. The outer surface of the brain consists of gray matter, 
which is mostly composed of nerve cells. The inner portion is mostly 
of white fibres, which connect with the cranial nerves, of which twelve 
pairs exist, 

An enumeration may be of interest and is as follows : 

1. Olfactory or nerves of smell. 

2. Optic or nerve of sight. 

3. Motor oculi or eye moving nerves. 

4. Pathetic or eye muscle nerves. 

5. Trifacial, nerves pertaining to orbits, jaw and parts of mouth. 

6. Abducens, supplying rectus eye muscle. 

7. Facial or nerves of the face and expression. 

8. Auditory or nerve of hearing. 

9. Grlosso -pharyngeal or nerves of tongue, palate and taste. 

10. Pneumo-gastric, or nerves which supply and regulate the or- 
gans of voice, respiration, the roof of mouth, gullet, stomach 
and heart. 

11. Spinal accessory, a nerve as its name implies and accompany- 

ing parts of the spinal nerves. 






THE NERVES. 


1. 


Brain. 


2. 


Small Brain. 


3. 


Spinal Cord. 


4. 


Face Nerves. 


5, 


Plexus of Arm Nerves. 


6. 


Arm Nerves. 


7. 


Wrist Nerves. 


8. 


Finger Nerves. 


9. 


Sciatic or Hip Nerves. 


10. 


Nerves between Ribs. 


(I. 


Leg Nerves. 


12. 


Saphenous Nerves. 


13. 


Nerves of Feet. 



NERVES. 9 

12. Hypoglossal, or motor nerve of the tongue. 

The cerebellum or small brain is situated beneath the rear por- 
tion of the large brain and is divided from it by a membrane. It 
consists of white and gray matter, but is not convoluted like the 
brain proper, but furred. 

The sympathetic nerves consist of a series of ganglia, connected 
together by intervening cords, and extending on each side of the 
vertebral column, from the base of the skull to the coccyx, they radi- 
ate irregular to all parts of the cavities of the body. Their functions 
are to preside over such actions of the organs as are beyond the con- 
trol of the will, such as the beating of the heart, the circulation of the 
blood, the digestion of the food, etc. 

Numerous communicating branches unite the sympathetic system of 
nerves with that of the spinal and cranial system. 

The diagram of the whole nervous system will give a clear insight 
of the distribution of the voluntary or nerves under our control, as 
well as of the sympathetic nerves, which act independently of the 
human will-power. The diagram is necessarily schematic and does 
not pretend to give each and every nerve fibre radiating in the human 
body. Like other illustrations it is drawn from recent dissections 
and best obtainable data. 

ORGANS OF SENSE. 

These are five in number — viz: touch, taste, smell, hearing and 
sight. 

Touch. The principal seat of this sense is the skin. 

The Appendages of the Skin are the nails, the hairs, sebaceous 
glands and their ducts. 

Taste. The tongue is the organ of the special sense of taste. 

Smell. What the tongue performs in taste, the nose does in 
smelling. By means of the peculiar properties its nerves possess, it 
protects the lung from inhalation of deleterious gases and assists the 
organ of taste in discriminating the properties food. 

Hearing. This sense comprises three distinct parts, the external, 
the middle and internal ear. 

The external ear consists of the expanded portion visible, named 
the auride and the auditory canal. The former serves to collect the 
vibrations of the air, by which sound is produced and the latter con- 
ducts these vibrations to the tympanum or ear-drum. It is in this 



10 ORGANS OF SENSE. 

canal that certain ceruminous glands secrete the ear-wax, which pro- 
tects, as long as moist, the ear drum, as well as prevents the entrance 
of insects, being a poison to them. 

The middle ear or tympanum is an irregular cavity and situated 
within the petrous bone, which by the way is of unusual hardness. 
In it is the tympanic membrane or drum -skin, which separates this 
cavity from the auditory canal of the external ear. This membrane 
receives the vibrations of the air and transmits them to the internal 
ear by the "chain of the bones" of hearing namely the Malleus or 
hammer, the Incus or anvil, and the Stapes or stirrup. These small 
bones are connected with each other and with the walls of the 
tympanum by ligaments, and moved by small muscles. 

The internal ear or labyrinth, is the essential pail; of the organ, 
receiving the ultimate distribution of the auditory nerve. It consists 
of three parts, viz: the vestibule, semi-circular canals and cochlea or 
shell of the snail. 

The vestibule is the central cavity of communication between the 
parts of the internal ear, and is situated on the inner side of the 
tympaum, behind the cochlea and in front of the semicircular canal. 

The semicircular canals are three long tubes situated above and 
below the Vestibule. These canals open into the vestibule by five 
orifices. 

The cochlea bears some resemblance to a common snail-shell, it 
forms the anterior part of the inner ear, conical in form and placed 
nearly horizontal in front of the vestibule. In this cochlea we find a 
special fluid, called, perilymph, which holds solid particles in suspen- 
sion, receiving the termination of the auditory nerve, destined to 
transmit to the brain the impressions of tonorous vibrations. 

Sight. The apparatus of vision comprises the globe of the eye and 
the accessory organs which serve to protect and to move it. The 
globe of the eye is a spherical mass composed of several superposed 
coverings. The most external, is the leeotic formings the white 
of the eye ; its front part is transparent, and has received the name of 
cornea. 

The next membrane, called choroid, is divided in front in two 
layers, one of which forms the iris, differently colored in different 
persons, and posessing in its centre an opening called the pupil. 
This opening can dilate and contract, and thus ft measures the quan- 
tity of the luminous rays, which ought to penetrate into the eye. 



ORGANS OF DIGESTION. 11 

The second layer of the choroid is the ciliary ring, situated be- 
hind the iris and in front of the crystaline lens, which is a bi- 
convex lens, transparent as crystal, as its name implies; its function 
is to refract the luminous rays. The partial or total capacity of the 
crystaline lens constitutes the disease known under the name of 
cataract. The crystaline lens is bathed in front by the aqueous 
humor, and behind it by the vitreous humor', these fluids are limpid 
and possess a refracting power, which is, however, less than that of 
the lens. 

The most important and also innermost membrane of the ocular 
apparatus is the retina, formed by the expansion of the optic nerve, 
which is destined to transmit to the brain the impressions of the im- 
ages painted on this membrane. 

The size of the eye is pretty much the same in all men, and the 
differences observable in this respect are dependent on the extent to 
which the eyelids are opened. 

The accessory parts of vision are the orbits, hollowed in the facial 
part of the skeleton, and containing the globes of the eye, the eyelids, 
the eyelashes and the eyebrows, organs destined to protect the eye 
from the irritation of foreign bodies, or from the impression of too 
strong a light. , 

The lachrymal glands, which secrete the tears and prevents the sur- 
face of the eye from becoming dry, and lastly, the muscles, which 
moves the eye in all direction, and the perverted action of which con- 
stitutes squinting. 

THE ORGANS OF DIGESTION. 

The apparatus for this purpose consists of the alimentary canal and 
certain accessory organs. 

The alimentary canal is a membranous tube, consisting of several 
coats, one of which is a muscular one. Its length is in the neighbor- 
hood of thirty feet, varying somewhat in different persons. It com- 
mences at the mouth and extends to the anus. It is subdivided into 
different but continuous sections, which are named as follows: 

The mouth, where mastication takes place, to which the following 
parts are accessory : The fleshy folds of the mouth — lips — forming 
the door to the entrance of the alimentary canal. The cheeks form 
the sides of the face and are continuations of the lips, in it are the 
muscles, which keep the food while in process of mastication under 



12 TEETH. 

the molars. The gums are the fleshy portions on the jaw-bone, sur- 
rounding the sockets of the teeth and their lower middle portions. 

The teeth. The human being is provided during life with two sets 
of teeth, which make their appearance at different periods of life. 
The first appear in childhood and are, what is commonly known as 
temporary or milk teeth. The second set, which also make their ap- 
pearance in early life, are the permanent teeth and these remain in 
tact, when properly cared for until old age. 

The temporary teeth are twenty in number, four incisors, two 
canine and four molars in each jaw. 

The permanent teeth are thirty -two in number — four incisors, two 
canine, four bicuspids and six molars in each jaw. 

Each tooth consists of three portions, the crown or body, project- 
ing above the gums ; the root, entirely concealed and firmly imbedded 
in the sockets of the jawbones and the neck, bring that part between 
the other two portions. 

The temporary teeth make their appearance about as follows : 
Central incisors seventh month. 

Lateral do seventh to tenth months. 

Anterior molars twelfth to fourteenth month. 

Canine fourteenth to twentieth month. 

Posterior molars eighteenth to thirty-sixth month. 

The teeth of tne lower jaw make their appearance a little sooner 
than those of the upper. 

The eruption of the permanent teeth takes place at the following 
periods. 



First molars 


6J years. 


Two middle incisors 


7th year. 


Two lateral incisors 


8th year. 


First bicuspid 


9th year. 


Second bicuspid 


10th year 


Canine 


11th to 12th year. 


Second molars 


12th to 13th year. 


Wisdom teeth 


17th to 21st year. 



The palate forms the roof of the mouth, consisting of two portions, 
the hard in front and the soft palate behind. 

In the cavity made by the roof of the mouth and dental arches is the 
tongue. 



ORGANS OF DIGESTION. 13 

The salivary glands which furnish the salivia are three in num- 
ber, and are located as follows : 

The parotid, in front of the ear. 

The submaxillary, below the jaw. 

The sublingual, is the smallest, beneath the mucous membrane of 
the floor of the mouth. 

The pharynx is that part of the alimentary canal, which is placed 
behind the nose, mouth and larynx. It has openings communicating 
with the nose, the two ears by the eustachian tubes, the mouth, 
larynx and gullet. 

The gullet or oesophagus is a muscular canal extending from the 
pharynx to the stomach ; about nine inches in length. 

The greatest portion of the alimentary canal is situated in the 
abdomen, by far the largest cavity in the human body. In it is also 
located the principal organ of digestion. 

The stomach, which is the most dilated part of the alimentary 
canal, serving for the solution and reduction of food, which constitutes 
the process of chymification or stomachial digestion. It is situated in 
the left hypochondriac and epigastric regions. It is placed immedi- 
ately behind the anterior wall of the abdomen, above the transverse 
colon, below the liver and diaphragm. It varies considerable in size 
in different persons, but also according to its state of distension. 
When moderately filled it measures about 12 inches transversely 
and its vertical diameter is about four inches. On the upper left por- 
tion it is connected with the gullet and on the right or minor portion 
it forms a junction, through the pyloric orifice, usually called the pit 
of the stomach, with the small intestines. 

The small intestine is that part of the alimentary canal in which 
the chyme is mixed with the bile, the pancreatic juice and the intesti- 
nal fluids and the separation of the nutritive principle of the food, 
the chyle, is thus effected, constituting chylifi cation. 

The small intestine is a convoluted tube about twenty feet in length, 
and gradually diminishes in size from its commencement to its ter- 
mination. The small intestine is divided into three portions, the 
duodenum, the jejpnum, and the ilium. 

The duodenum has received its name from being about equal in 
length to the breadth of twelve fingers (8 to 10 inches). It is the 
shortest, widest and most fixed part or the small intestine. In it 



14 THE VILLI. 

terminates the common duct, which brings to the intestine the bile 
and pancreatic juice, so needful-in digestion. 

The jejunum (empty) so called from being usually found empty after 
death, includes the upper two-fifths of the rest of the small intestine. 
It commences where the duodenum ceases and terminates in the ilium. 

The ilium (twist) so called from its numerous coils or convolutions 
includes the remaining three fifths of the small intestine. 

Villi, which are very minute, highly vascular processes projecting 
from the mucous membrane and gives to its internal surface a sort of 
velvety appearance. The villi are largest and most numerous in the 
duodenum and jejunum and become fewer and smaller in the ilium. 
It has been estimated that throughout the small intestine are about 
four million of these small villi. The essential parts of the villi are 
the lacteals and blood vessels. 

The purpose and office of the villi and blood vessels is the withdrawal 
from the food as it passes through the alimentary canal of such mat- 
ter as is fit for blood building substances; namely, the chyle and sub- 
stances entering the blood direct. These villi are connected through, 
the chyliferous vessels imbedded in the mesenteria with the thoracic 
duct and lymphatic system in general, heretofore minutely described. 

The large intestines extends from the termination of the ilium to 
the anus and is about five feet in length. It is largest at the com- 
mencement of the caecum or blind intestine and gradually diminishes 
as far as the rectum, when there is a dilation of considerable size just 
above the anus. The large intestine describes an arch which sur- 
rounds the convolutions of the small intestines. The large intestine 
is divided into the caecum, or blind intestine, the colon and the 
rectum. 

The caecum is the large blind pouch or cul-de-sac as the French 
call, it in which the large intestine commences. Its length is about 
2J- inches and its breadth about 3 inches. The caecum lies quite free 
in the abdomen and enjoys considerable amount of movement. 

Attached to its lower end in the appendix vermifonnis a long, 
narrow worm-shaped tube. It is in this tube, that sometimes grape 
stones or other seeds are lodged, and are not dissolved. This 
lodgement is very dangerous. 

The lower end of the ilium terminates at the inner and back part 
of the caecum and forms a valve which prevents any influx from the 
large intestine into the small one. 



OKGANS OF DIGESTION. 15 

After the caecum and ascending in the right side comes the colon 
and when this part of the large intestine reaches the liver it trans- 
verses from right to left across the abdomen, crossing about where the 
umbilicus or navel is located. At its termination it descends on the 
right side of inner abdomen forming the so ealled sigmoid jleocure in 
the shape of a roman S and empties into the rectum, the terminal 
part of the large intestine and through which the excrements leave 
the body by way of the anus. 

The liber is a glandular organ of large size mainly intended for 
the secretion of bile. It also affects important changes in certain con- 
stitutients of the blood in its passage through this gland. It is situated 
in the right hypochondriac and epigastric regions. It is the largest 
gland in the human body, and taking up about 1-32 of its weight. 
The liver consists of two lobes the right, by far the largest, and the 
left, the proportion being about six to one. 

Numerous blood vessels enter and leave the organ. 

In structure it is composed of lobules, held together by extreme 
fine tissues and the ramifications of the portal vein. 

The gall bladder is the reservoir for the bile ; it is a pear-shaped 
sac lodged under the surface of the right lobe of the liver, and ex- 
tends slightly below the lower portion. 

The liver duct and gystic duct unite and form the common duct 
and through these the bile is conducted into the duodenum. 

The pancreas, the same as what is known in the animals serving 
as food, as sweet bread, is a gland which resembles the salivary. It is 
somewhat flattened and situated transversely in the posterior portion 
of the abdomen. This gland secretes the pancreatic juice, alkaline in 
its nature, and which is conducted through the pancreatic duct into 
ihe douednum, usually joining the common duct just prior to its en- 
trance, but sometimes effecting a separate entrance into the small in- 
testine. 

The spleen is a gland laying back and to the right of the stomach. 
It varies much in size, even in one person at different stages. It is 
highly vascular of a bluish red color, soft, of a rather brittle con- 
sistency. Its functions are unknown to science. All these organs 
are inclosed in a thin membrane, the •peritoneum. 

For the location of the digestive organs and their accessories and 
connections, the reader is referred to the fine engraved plate, which 



16 THORAX. 

will show him the wonderful machinery requisite, to transform the 
food into chyle, and how the latter enters the blood current, becomes 
purified and serves to rejuvinate the exhausted body. 

THE THORAX OR CAVITY OF THE CHEST. 

The Thorax is a conical frame-work, formed partly of bones and 
partly of the soft tissues, by which they are connected together. 

It is bounded by the ribs, the muscles between the ribs and the 
backbone; and at its lower portion by a very thin muscle, the 
diaphragm . 

The cavity thus formed, contains the heart, enclosed in a mem- 
braneous sack called thepericardium; and the lungs, invested by 
the pleura. 

The heart is a hollow muscular organ of a conical form, placed be- 
tween the lungs in the cavity of the pericardium. The heart is 
placed behind the lower two-thirds of the breast-bone and projects 
farther to the left than to the right cavity of the chest in an oblique 
position. The lungs cover part of the heart and during inspiration, 
the borders nearly meet behind the sternum^ 

The heart in an adult is about the size of the fist, and weighs from 
10 to 12 ounces in the male and from 8 to 10 ounces in the female. 
The heart continues to increase in weight, also in length, breadth and 
thickness, up to an advanced period of life, while other parts of the 
human system have a tendency to decrease, after full maturity. 

The heart is divided into four chambers : 

1st. The right auricle. Into it opens the vena cava, or hollow 
vein of the body. 

2nd. The right ventricle. It receives the venous blood through 
the right auriculo- ventricular valve and forces it through the pulmonary 
artery into the lungs. 

3rd. The left auricle, somewhat smaller than the right, receives, 
by way of the pulmonary veins, the purified blood, back from the 
lungs, and forces it through the left auriculo — ventricular valve into: 

4th. The left ventricle, which is longer and more conical m 
shape, having much thicker walls, than the right side, in proportion 
of 3 to 1. From it the purified blood is forced, by way of the aopta 
or great artery and its numerous branches to all parts of the body. 

The manner in which the blood courses through the heart is graphi 




1. 


Jugular Vein. 


2. 


Carotid Artery. 


3. 


Oesophagus or 
Gullet. 


4. 


Vena Cava. 


k 5. 


Aorta or Great 




Artery. 


m 6. 


Veins and Art- 


J|M| 


eries of Arm. 


Ml 7. 

HH r 


Kidney. 

Liver. 

Stomach. 


111 io. 

E I) Mflf 


Lungs. 


fl "" 


Heart. 


H fjl 12. 


Pylorus 


Hill i3. 


Duodenum. 


wlf l4. 


Other Small In- 




testines. 


lllB 15. 


Caecum or 


[H|f|uw 


Blind Intestines. 


iBf ,6, 


Large Intestine. 


Big 17. 


Arteries and 




Veins of Lower 




Extremities. 


llllk 18. 


Rectum. 


^^^%I9. 


Ureters, 


llm 20, 


Thoracic Duct. 


111 21. 


Pancreas. 


22. 


Spleen. 


23. 


Gall Bladder. 



VOICE. 17 

cally shown on the plate of Blood Formation and Circulation, the direc- 
tions being indicated by arrows. 

ORGANS OF VOICE AND RESPIRATION. 

The larynx is the organ of voice and is situated at the 
upper part of the air passage between the windpipe and root of 
the tongue, at the upper and forepart of the neck. It can be plainly 
felt, its foremost projection being the Adam's-apple. The larynx 
harbors the vocal cords, which, through the striking of the air, as it 
comes from the lungs, vibrate, which makes sound, and through the 
actions of the mouth are moulded into words, song, etc. 

The trachea or windpipe is a continuation downward of the 
larynx and consists of a cartilagenous and membraneous cylindrical 
tube, somewhat flattened posteriorly. It extends downward about 
4-L inches, when it divides in a right and left branch. One for each 
lung. These branches are called bronchi. 

The right bronchus is wider and shorter than the left and measures 
about one inch in length. 

The left bronchus is smaller, but longer, measuring about two 
inches. 

Tracheal glands are found in great abundance at the posu^rior 
part of the windpipe. The secretion from these glands serves to 
lubricate the inner surface of the windpipe. 

Each lung is invested upon its external surface by an exceedingly 
delicate serous membrane, the pleura, which encloses the organ as 
far as its root and then reflects upon the inner surface of the thorax. 

The lungs are the essential organs of respiration ; they are two in 
number, placed in each of the lateral cavities of the chest, separated 
from each other by the heart. Each lung is divided into two lobes 
an upper and a lower, by long and deep fissure, which nearly pene- 
trates to the root. In the right lung the upper lobe is partially 
divided by a second and shorter fissure, thus marking off a small tri- 
angular portion, the middle lobe. 

The right lung is the heavier, it is broader than the left, owing to 
the inclination of the heart to the left side. 

In structure it is spongy and elastic, made up of numerous air- 
cells, on the internal coats of which the capillaries of the pulmonary 
artery and vein are formed, and it is here that the venous blood gives 



18 GENERATIVE ORGANS 

of its carbonic acid, partakes of oxygen it finds in air and returns the 
blood by last mentioned bloodvessel to the heart. 

THE URINARY ORGANS. 

The two kidneys are situated in the back of the abdomen, and are 
for the purpose of separating from the blood certain materials which, 
when dissolved in a quantity of water, also separated from the blood 
by the kidneys, constitute the urine. 

They are situated on the loins, one on each side of the vertebral 
column, behind the peritoneum and usually surrounded by a mass of 
fat and tissue. 

Sometimes, instead of being fixed in place by this tissue, the 
kidney is loose and only held by the ureter and the blood-vessels. It 
is then called floating or wandering kidney. 

The kidney is bean-shaped in form of a deep red color. It receives 
the blood from the kidney artery, a branch of the aorta, relieves it of 
the constituent parts of urine and surplus water, conducts the residue 
back to the venous system by way of the kidney vein into the lower 
vena-cava, and eliminates the urine through the ureter, which empties 
into the bladder from which it is discharged through the male or 
female urethra and thus eliminated from the body. 

MALE GENERATIVE ORGANS. 

The prostrate gland is a pale, firm, glandular body, which sur- 
rounds the neck of the bladder and commencement of the urethra, 
In shape and size it resembles a chestnut. This gland is perforated 
by the urethra and common seminal ducts. 

Cowpers glands are two small rounded bodies, of a yellow color, 
about the size of peas, placed beneath the forepart of the membran- 
ous portion of the urethra, between two layers of deep fascia. Their 
excretory ducts open into the bulbous portion of the urethra. Their ex- 
istence is said to be constant, but they gradually decrease in size as 
age advances. 

The penis is the organ of copulation and contains in its interior 
the larger portion of the urethra. It consists of a root, body and ex- 
tremity. The penis is composed of a mass of erectile fibres, possess- 
ing great elasticity, all being covered by a loose skin, which can be re- 
moved from the extremity, thus laying bare the mucous membrane of 
the gland, where a number of sebaceous glands are situated secreting 
a caseine mass, and becomes easily decomposed. It emits a peculiar 



FEMALE GENERATIVE ORGANS. 19 

odor. The frequent cold bathing of these parts cannot be too strongly 
recommended. 

The testes are two small glandular organs, which secrete the semen; 
they are situated in the scrotum, being suspended by the spermatic 
cords. 

_he scrotum is a skinny pouch, which contains the testes and part 
of the spermatic cord, it is divided into two lateral halves. 

The seminal vesicles are two lobulated membranous pouches, placed 
between the base of the bladder and the rectum, serving as reservoirs 
for the semen, and secreting a fluid to be added to the secretion of the 
testicles, by ducts entering through the prostrate gland into the urethra. 

The semen is a thick, whitish fluid having a peculiar odor. It con- 
sists of a fluid, the semen liquor, and solid particles, the semen 
granules and spermatoza. The semen liquor is transparent, colorless 
and of an albuminous composition, containing particles of epithelium, 
with oil globules and granular matter floating in it, besides the 
above mentioned solid elements. 

The seminal granules are round finely — granular corpuscles, measur- 
ing 1-4000 inches in diameter. 

The spermatoza, or spermatic filament, are the essential agents in 
producing fecundation or impregnation. They consist of a flattened 
oval head, of a rod shaped middle piece and a long slender tail. The 
movements of these bodies are remarkable and consist of a lashing of 
the tail. 

FEMALE GENERATIVE ORGANS. 

The external female organs of generation, are the Mons Veneris, or 
that fatty collection, which in grown persons is covered by hair. 
The large and small lips, which are two pairs of longitudinal folds, ex- 
tending down from the Mons Veneris. 

The clitoris is an erectile structure analogus to the penis in males. 
A little below this is the orifice of the urethra, through which the 
urine is discharged. Below this orifice is the opening of the vagina, 
an eliptical aperture, more or less closed in thevrigin, by a membran- 
ous fold. 

The hymen, which is stretched across the lower part of the orifice 
of the vagina. Sometimes this hymen forms a complete curtain over 
the orifice of the vagina and occasionally it is in the shape of a circu- 
lar arrangement, perforated in the centre by a round opening. Then 



20 FEMALE GENERATIVE ORGANS. 

again it is found in the form of a fringe, and frequently it is entirely 
absent. It may even continue to exist after copulation. In conse- 
quence of these facts, the hymen can not be considered as a test of 
virginity. 

The vagina lies back of the bladder and in front of the rectum, and 
is a membranous canal extending to the uterus or womb. At the 
commencement it is considerably constricted widening out towards 
the womb. 

The uterus or womb is the organ of gestation, receiving the fecundated 
ovum in its cavity, retaining and supporting it during the development 
of the foetus and becoming the principal agent in its expulsion at the 
time of childbirth. 

The ovaries are analagous to the testes in the male, and are situated 
on each side of the womb. 

The oviducts convey the ova (egg) from the ovaries to the cavities of 
the womb. These tubes quite frequently become the seat of female 
troubles, such as inflammation, followed by local dropsy or accumul- 
ations of pus, of blood, etc. However, easily remedied by the surgeon. 

In the internal ovaries small round transparent vessels are found, 
containing the egg. 

The formation of these vessels containing ova continue uninter- 
ruptedly from infancy to the end of the fruitful period of woman's life. 
Before puberty the ovaries are small and their ova being incapable of 
impregnation. At puberty these organs enlarge and their ova are cap- 
able of fecundation. 

The small vessels containing the egg, after gradually approaching 
the surface of the ovary, burst, the egg and fluid contents are liberated 
and escape on the exterior of the ovary, passing then into the oviducts, 
and into the womb and if at this period the union of the sexes takes 
place, the ovum or egg may be impregnated. 

Numerous ligaments surround the womb and cvaries and hold these 
organs in place. 

The mammary glands or breasts are accessory to the generative sys- 
tem and secrete the milk. They exist in the male as well as in the 
female, but in the former only in a rudimentary state. Frequently 
in the female these glands are the seat of tumors. Before puberty 
they are of small size but enlarge as the generative organ becomes 
more completely developed. They increase during pregnancy, and 
especially after delivery. 



BLOOD. 21 

The fluid upon which the human as well as all animal bodies sub- 
sist, is the blood, which, Webster describes as follows: " The 
fluid which circulates in the principal vascular system (veins, arteries 
capillaries) of animals, carrying nourishment to all parts of the body, 
and bringing away waste products to be excreted." 

The blood is a thickish, opaque fluid, of a bright red or scarlet 
color, when it flows from the arteries, of a dark red or purple color 
when it flows from the veins. It is sticky and has a somewhat 
clammy feeling ; it is salt to taste and has a peculiar faint odor. Its 
temperature is generally about 100 ° Fahrenheit, but varying slightly 
in different parts of the body. Blood consists principally of two dif- 
ferent constituents, namely, a nearly colorless transparent, alkaline 
fluid, the plasma and of distinct little bodies, called corpuscles, swim- 
ming in the plasma. The corpuscles form about 40% and the plasma 
about 60%, of the entire mass. 

The quantity of blood in the healthy human body is about one- 
eight part of its weight. 



THE FUNCTION OF NUTEITION. 

T T AVINGr briefly considered the different organs composing the 
(pH Human Body, which are destined to accomplish the acts of life, 

(«) and are called f mictions. 

These functions are divided into two distinct classes, namely, 

1st. The functions of nutrition, the purpose of which is to provide 
for the preservation and increase of the human body. 

2d. The functions of relation, which place man in relation with the 
beings around him. 

To the first are assigned the apparatus of digestion, circulation, and 
respiration ; to the latter the apparatus of locomotion, the nervous sys- 
tem and the organs of sense. 

FUNCTION OF NUTEITION. 

1. Digestion. Digestion is a function which causes the alimentary 
substances introduced into the digestive apparatus to undergo different 
modifications, having for their object the transformation of those sub- 
stances into two parts ; the one nutritive, the chyle, which renovates 
the blood and reconstitutes our organs; the other, non-assimilable, 
the excrements or semi-solid residue, which is cast off from the system. 

Digestion comprises a series of successive acts which are: 

1. The prehension of food, 

2. Mastication. 

3. Insalivation. 

4. Deglutition. 

5. Stomachial digestion, or chymification. 

6. Intestinal digestion, or chylification. 

7. Digestion in the large intestine, and defaecation. 

The first act is performed by man, by his hands, in carrying the 
food to his mouth. 



MASTICATION. 23 

Mastication is performed by the teeth alone and in their absence, or 
artificial teeth, the gums try it very hard, but usually make a bad job 
of it. Insufficient mastication is a frequent cause of indigestion 
in persons who are without teeth, or in those who eat too fast. 

Insalivation. This stage of digestion is accomplished, like the pre- 
ceding, in the mouth. Its function consists in soaking and covering 
the food, bruised by the teeth, with a colorless and ropy liquid, the 
saliva. This liquid is secreted in a great measure by three pairs of 
glands heretofore described. These are the glands, which, at the sight 
or recollection of a delicate dish, make, as it is said, "the mouth 
water." 

The saliva has two uses, one mechanical and the other chemical. 
The first has for its object to assist the mastication and deglutition of 
food, and the second, under the influence of a peculiar ferment, called 
salivary diastase, transforms starchy food into a saccharine and soluble 
substance, called glucose. 

The sweet taste acquired by a piece of bread chewed for a certain 
time in the mouth is due to this chemical reaction and not to imagi- 
nation. 

Deglutition or swallowing. This period of digestion comprises the 
different mechanical actions which occur in making the food pass 
from the mouth into the stomach, which passage is affected in the 
following manner: The food sufficiently divided by the teeth, 
has been collected into small masses ; the tongue is hollowed into a 
gutter like form, is elevated from the point to the base, supported on 
the palatine vault, and it directs these small masses towards the 
openiug of the gullet over which they pass. At the same time the 
pharynx is elevated and comes in front of the mass of food, sizes them, 
and incloses them in the gullet, where the muscular contraction of 
this tube, together with the force of weight, carry the food down as 
far as the stomach. 

There is a mechanism which prevents alimentary substances from 
penetrating into the windpipe. In fact the larynx applies its lid, the 
epiglottis, under the base of the tongue and thus closes the upper 
orifice of the respiratory tube. If this membranous valve, the epi- 
glottis, remains raised in consequence of an unreasonable fit of 
laughter, or an ill managed inspiration, alimentary fragments are in- 
troduced into the respiration passages and excite paroxysms of suffo- 
cation, which may cause death. It is said that a grape stone caused 



24 CHYMIFIOATION. 

the death of Anacreon, a convivial and jolly Greek poet, by penetrating 
the lamyx, while he was laughing. 

Chymification or stomachial digestion. The alimentary mass enters 
the stomach by the lower orifice of the gullet, and there it remains 
until it is transformed into a rose colored and greyish paste, the 
chyme. 

This transformation is effected under the influence of a liquid, 
secreted by the glands contained in the walls of the stomach, namely, 
the gastric juice, which contains an organic ferment, pepsine, endowed 
with the property of changing azotized foods, such as fibrine, albumen, 
etc., etc., into a soluble and assimilable substance, albuminose or peptone. 

The stomachial digestion being completed, the chymous paste is 
inclosed in the small intestine by the pylorus, a conical orifice, which 
establishes the communication between the stomach and the intestinal 
canal. The pylorus corresponds to the part of the abdomen, commonly 
called the pit of the stomach, and it is in this region that we most fre- 
quently ascertain the presence of a tumor in the case of persons suf- 
fering from cancer of the stomach. In such persons digestion is slow 
and sometimes impossible, in consequence of the more or less complete 
obstruction of the pylorus. 

The faulty position of children who rest their chest on the edges of 
the table at school, and the more or less continued pressure, exercised 
in certain callings, on the epigastric region produce disturbances in 
^he functions of digestion and may at length induce lesions of the 
stomach of a serious nature. Tailors and shoemakers, for instance, 
being obliged to have the trunk always bent forward, are liable to 
painful forms of indigestion. 

It is difficult to fix exactly the period occupied by the stomachial 
digestion, for the time is proportionate to the nature of the alimentary 
substances, to the degree of energy of the contractions of the stomach, 
and to the activity of the secretion of the gastric juice. Nevertheless, 
it is estimated that its duration is three hours. 

Instead of passing into the small intestine, it may happen that the 
alimentary matters take a retrograde course, and are thrown out of 
the system, as is observed in vomiting. 

Intestinal digestion or chylification. The food reduced to the state of 
chyme, passes through the pylorus, as we have just explained in preced- 
ing paragraphs and traverses successively the three portions of the 
small intestine — duodenum, the jejaunum, and the ilium. The alimen- 



BILE. 25 

tary mass receives in the duodenum, through the common duct, the 
bile coming from the liver and the pancreatic juice from the pancreas. 

These two liquids are destined to complete the action of the saliva 
on the starchy food, and that of the gastric juice on the azotized food; 
and, thus, they co-operate, together with the intestinal juice, which, 
moreover, is not unconcerned in the proceeding transformations, in 
dividing the fatty kinds of food into very fine particles, which become 
capable of being absorbed by the walls of the intestine. 

Pancreatic juice is pre-eminently the dissolverof fats, by changing it 
into an assimilable emulsion, not due to its alkaline reaction, however, 
but to the organic matter it contains. Fats are not affected by either 
salivia or gastric juice, and examination shows that they are unchanged 
in their essential characters so long as they remain in the stomach. 
In this organ they are, through the warmth of the body, simply liqui- 
fied. But almost immediately after passing into the intestine, the 
fatty portion of the food is changed by this pancreatic juice into the 
emulsion above referred to, and called chyle, which is then ready for 
absorption. Its Second important action is the transformation of 
starch into glucose. It is more effective in this respect than saliva, 
being almost instantaneous. 

Bile, the secretion of the liver, and as it comes from the gall blad- 
der, is a clear, more or less ropy fluid, of neutral or alkaline reaction, 
with a faint animal odor. In color it is yellowish bronze green. 
While bile is largely a matter of excrement, the blood desires to get 
rid of, it is a fact that it also performs important functions in diges- 
tion. It also aids in the neutralization of gases which are created in 
the intestinal track during digestion. Thus we observe, when our 
liver does not furnish a sufficient quantity of bile for the condensation 
of these gases, maladorous winds will escape the anus. This may be 
surely attributed to an inactive liver. While the researches as to the 
function of the bile are based more on theories than facts, it may be 
accepted as evidence that it exercises its influence to exciting the 
muscular action of the intestine, and thus serving as a stimulus to its 
movement. That bile is a necessary adjunct to digestion is well 
known and borne out by facts, but in the manner it performs these 
functions is somewhat enveloped in obscurity. 

The small intestine also furnishes juices, acting as dissolving agents 
of the alimentary substances. 

The total length of the small intestine varies in different classes of 



26 BILE, 

animals. It is dependent on their mode of alimentation, In the 
carnivora or exclusive meat eating animal, the length is nearly three 
times that of the body; in the herbivora, or vegetable eating animal, 
it is more than ten times greater than the length of the animal. 
The intestine of the sheep is twenty-seven times the length of the 
body. 

As to man, who in his quality of omnivorous being holds a middle 
rank between the others just mentioned, the length of his digestive 
tube is five or six or sometimes seven times that of his height. 

The most striking example of the relation existing between the 
digestive tube and the nature of the food taken is certainly that, 
which is furnished us by the frog. In fact, in the foetal or tadpole 
state, this animal feeds only on aquatic' plants, and its intestine 
measure ten times the length of its body, but in the adult state, when 
it eats flesh and principally insects, its intestine is only twice as long 
as the body. 

From these facts of comparative anatomy, it may be concluded that 
vegetable matter takes a longer time to digest than animal substances. 

It would be interesting to inquire whether the intestine of the in- 
habitants of hot countries, who live chiefly on vegetables, is longer 
than that of the inhabitants of cold climates, who consume largely the 
fat and the flesh of animals. 

The progress of the alimentary matters along the numerous convo- 
lutions of the small intestines is assisted by the contraction of the 
muscular fibers of this tubes, and, on the other hand, it is retarded by 
the numerous folds, called "valvulae convenienets," which thus in- 
crease the extent of the intestinal mucous membrane ; and thereby 
multiply the absorbing surfaces. These mucous folds are bristled 
with an incalculable number of little projections, called intestinal 
villi, presiding over the phenomena of absoiytion, which is the object 
of digestion. 

These little organs, which are true animal roots, receive in their 
interior the minute extremities of ten chyliferous vessels, and those 
of the ramifications of the portal vein, the office of which is to draw 
up by imbibation, and not by suction, the alimentary juices or chyle, 
formed by the process of digestion. 

These chyliferous vessels absorb all the elements of the chyle, they 
convey them into the thoracic duct and this duct pours this blood 
building mass into the circulating blood current at the point of union 



URINATION. 27 

of the internal jugular vein and under shoulder vein of the left 
side. 

The tributaries of the portal vein, located in the stomach and intes- 
tine, take up the elements which enter into the constitution of the 
chyle, with the exception of the fatty matters; they conduct these 
elements into the liver, through which they pass, and then they pene- 
trate into the inferior vena cava, by the liver veins. It is therefore 
through the medium of the venous system, that the chyle passes into 
the general circulation. 

Digestion in the large intestine. In the pissage across the large 
intestine the remainder of the alimentary matter still contain a cer- 
tain quantity of chyle, which is given up for asorption, and then these 
nutters assume a certain consistency, and acquire a smell, which is 
the stronger in proportion as the food is more azotized. Thus the 
excrements of the vegetable eating class emits a less disagreeable 
odor, than those whose diet consists mostly of animal food. The 
absorbing power of the large intestine is utilized in the administration 
of nutritious and medicinal injections. 

Urination. The urine is to the nutritive liquors, what the excre- 
ments are to the solid aliments. The liquids unsuited for nutrition 
then are eliminated from the body in great part by the kidneys. 
These organs are formed of a certain number of niters, which give 
passage to all the impurities contained in the blood, and thus the 
urine is formed. The urine is a colored fluid containing 93% water 
and 2% of azotized principle, urea, and 5% of other organic matter 
and salts. 

From the kidneys this liquid flows through the ureters delivering 
it into the bladder to be externally discharged by the urethra. 

An adult excretes on the average about three pints of urine each 
day. During the summer, or after profuse sweating, the urine di- 
minishes in quantity. It sometimes deposits, in its course along the 
urinary passages, concretions which constitute, according to their 
dimensions, sand, gravel and stone. The passages of these concretions 
in the interior of the ureter causes severe pain, and which are the 
more acute as the volume of these foreign bodies is larger. 

The mechanism is analogous to that which gives rise to hepatic 
colic, at the time of the passage of the gall stones into the interior of 
the ducts leading towards the intestine. 

Pure water, swallowed in large quantity, has the effect of dissolv- 



28 CIRCULATION. 

ing these lime like concretions and preventing their agglomeration 
into larger bodies. 

We may also find accidentally in the urine, blood, sugar, bile, 
albumen, mucous and pus arising from inflammation of the urinary 



The smell of urine, slightly ammoniatal in the normal state, is 
more powerfully so in different morbid conditions; it is also modified 
by certain essences, which select the kidneys as organs of elimination, 
and among the number we may mention asparagus, which gives the 
urine a disagreeable smell, which vinegar has the property of dimin- 
ishing without removing entirely. 

Circulation. The circulation comprises the transmission of the 
blood from the respiratory apparatus to all the organs of the body, 
and the return of the blood from these organs to the same apparatus. 

The circulating apparatus destined to perform this office is com- 
posed of an organ of propulsion, the heart, and numerous ramified chan- 
nels, namely, the arteries, the veins and the capillaries, heretofore 
minutely described. It might be interesting for some of our readers, 
to state that the heart is insensible, as Harvey (the renouned doctor 
who first drew attention to the fact that the blood circulates in our 
bodies,) demonstrated before Charles I., of England, by making that 
monarch touch the heart of Lord Montgomery's son, which had been 
laid bare by a wound of the sternum. The pain which is often re- 
ferred, to the heart, is most commonly produced by simple neuralgia 
of the thoracic wall. 

The right heart is destined to convey the dark or venous blood and 
the left heart presides over the circulation of the red or arterial blood. 

The arteries undergo distensions at every contraction of the heart, 
but by their elasticity they return to their former condition as soon as 
the heart's impulse terminates. This movement of dilation and ele- 
vation of the arteries constitutes the pulse, analogous with the beat- 
ing of the heart. 

When persons are growing old the walls of the arteries become 
fatty and lose the property of contraction, and they allow themselves 
to be gradually distended by the impulse of the blood, and may form 
at the most altered parts, dilations which are called aneurisms. 

If this alteration exists in vessels of weak calibre, like those of the 
brain, there is, generally, produced rupture of the walls, which give 
rise to hemorrhage or cerebral apoplexy. 



PULSE. 29 

The walls of the veins not being elastic are unable to return to their 
normal condition, when they have been too long distended and they 
present in such a case permanent dilations called varices, or varicose 
veins. The varices of the veins of the rectum have received the name 
of haemorrhoids or piles. 

That the course of the blood in the veins is not felt, is caused by 
the retarding innunces of the capillaries, while the blood passes 
through them. 

Pulse. The average frequency of the pulse in man is, for the adult, 
70 per minute. This rate may be accelerated by muscular exertion. 
Even the variations of muscular efforts, between standing, sitting and 
recumbent postures will make a difference in the frequency of the 
pulse of from 8 to 10 beats per minute. 

The pulse of a foetus before birth is about 140, and that of the 
newly born infant about 130 during the first, second and third years 
it falls to 100, by the fifteenth to 80, and is reduced to the adult 
standard by the 21st year. Pulse somewhat relaxes in age. A slow 
pulse is usually a strong one and a rapid pulse comparatively feeble. 
An excessive rapidity of the pulse is an indication of great danger and 
in the adult, a continual rate of 160 per minute is almost invariably a 
fatal symptom. 

Mechanism of Circulation. The venous blood flowing from all the 
regions of the body, arrives by the two venae cavae into the right 
auricle of the heart and thence into the corresponding ventricle, which 
propels it into the pulmonary artery, the ramifications of which are 
distributed in the substance of the lungs. The dark venous blood 
received by the lungs becomes arterial, or red, by the contact with 
air, and returns, thus modified, by the pulmonary veins into the left 
auricle, whence it passes into the ventricle of the same side. The 
contractions of the left ventricle propel the current of the blood into 
the Aorta, and thence into the whole of the arterial system as far as 
the capillaries, where the blood leaves its nutritive materials in the 
tissues of the body. From the capillaries it returns at last to the 
heart by the veins, which we have selected as the point of departure of 
this circular journey. The heart may, therefore, be justly compared 
to a forcing-pump, which feeds itself. 

The blood takes only about 30 seconds to make the entire round of 
the circulation, and consequently in twenty-four hours, a blood cor- 
puscle traverses 2,880 times the double circulatory circle, which is 
equal to a speed of about seventeen miles an hour. 



30 CIRCULATION. 

The niore active the circulation is in any organ, the greater tendency 
there is to the development of that organ. Hence it happens , that the 
right arm is stronger than the left, though not so in left-handed 
persons, and that the lower limbs of dancers are more developed than 
the upper ones. 

The facility with which the emotions of the mind act upon the 
heart lead us to attribute to this organ all the sentiments we feel. 
Thus we find in all languages, sayings and proverbs, which make the 
heart the source of our passions; hence the expressions, a heartless 
man, or a hard heart, a good heart, a brave and noble heart, and a 
broken heart, to characterize selfishness, goodness, courage, generosity 
and sorrow. In the same sense, one hears the exclamation: "All 
great thoughts come from the heart." 

Bespiration. The respiratory function has for its object the trans- 
formation of the dark venous blood into red arterial blood. The ap- 
paratus performing this duty has been described before under the 
organs of Voice and Respiration. The seat being in the chest and 
neck and it remains only to describe its physical and chemical 
phenomena. 

Animal Heat. In accomplishing its vital functions the arterial 
blood loses its nutritive qualities, and is converted into venous blood. 
It is by respiration that this venous blood is revivified and transformed 
into arterial blood, after having got rid of the carbonic acid it contains 
and having been saturated with the oxygen gas of the air. This 
interchange of the two gases is affected in the lung vessels, or aircells, 
and constitutes the phenomenon of hematosis, or arterialization of 
blood in the lungs, an act exclusively physical and conformable to 
the laws of the absorption of gases by liquids. 

The respiration of plants is altogether opposite to that of man, 
since it consists in the absorption of carbonic acid and the exhalation 
of oxygen. There ensues from this circumstance a kind of salutary 
antagonism between the two principal kingdoms of Nature, the 
animal and the vegetable. 

The mechanism of respiration comprises two periods, inspiration 
and expiration. Life begins with the first and ends with the second. 
These respiratory movements are effected, on the one hand, by the 
ascent and depression of the ribs, and, on the other, by the lowering 
and raising of the diaphragm, which, by pushing forward the viscera 






ANIMAL HEAT. 31 

of the abdomen, depresses the walls of this cavity or causes them to 
project. 

In the child the respiratory movements are manifested, by the ele- 
vation of the belly, and this is what is usually called abdominal respir- 
ation. In the adult man we notice the elevation of the lower ribs 
and that of the abdominal walls, but in woman, in breathing, moves 
only the upper ribs. This kind of respiration is peculiar to the female 
sex, and is not caused by the use of stays. 

The movements of respiration take place in a pretty regular manner, 
and about twenty may be counted in a minute. 

At each inspiration about forty cubic inches of air are introduced 
into the lungs, and this is pretty nearly the seventh of the whole 
quantity which these organs can contain. 

Thus in one minute the lungs receive about 12 quarts of air, in an 
hour 720 quarts, and in a day about 4,320 gallons. There is only 
about one-fourth part of the oxygen retained, while the amount of 
carbonic acid exhaled is rather smaller than the volume of oxygen 
absorbed. 

At each expiration the lung does not get rid of all the air it con- 
tains; the latter is only gradually removed. Henca comes the estab- 
lishment of quarantines, applied to vessels, returning from countries, 
where contagious diseases prevail. 

The carbonic acid exhaled by animal respiraiion tends to vitiate the 
air, and when the atmosphere contains more than three-tenths of this 
gas, respiration is altogether impeded. It may even be affirmed that 
the air is unhealthy before this limit is reached. 

The absorbed oxygen presides over some of the chemical reactions, 
which occur in the economy; and the combined action of w'hich con- 
curs in producing the animal heat. 

The temperature of man, taken under the shoulder in all seasons, is 
98° Fahrenheit; it has been known to raise to 107°, and even to 
113 ° , which is the extreme limit in disease. 

FUNCTIONS OF EELATION. 

It is by the functions of relation, that we are placed in relation, 
with the external world, that we receive thence sensations, and that 
they execute movements. The organs which concur in these two 
orders of distinct phenomena form the apparatus of locomotion, and 



32 FUNCTIONS OF KELATION. 

the apparatus of sensation. The first comprises the bones, the 
muscles, and the joints; the second has under its domain, the nervous 
system and the organs of sense. 

The body as servant of the soul. Let us for a few moments concen- 
trate our thought upon the master and then consider the functions of 
the servant 

From the anatomical description of the nervous system in this 
work, we have learned the location of the grey nervous matter, or 
nerve cells ; namely, in the outer stratas of the brain, the internal 
part of the spinal cord and ganglia of the sympathetic nerves. It is in 
these nerve cell,s where we find the seat of our sensibilities, the origin 
of thought and of movement. It is surely the mingling ground of 
body and soul, of matter and mind. It is, therefore, not to be won- 
dered at, that if this intricate part of the human body is infringed upon, 
either by its nutriment or overtaxed, or through extended passivness 
becomes corroded, that symptoms manifest themselves, which we see 
in cases of apoplexy, paralysis, delerium, madness, melancholia, in 
fact in all our thoughts and actions. The soul of man, during life, 
exerts its influence only through the body, its abode, and its intimate 
connection is surely the phenomena which science may try, but not 
succeed to penetrate. The usefulness of our mental faculties depend 
solely for their success upon the body, modified and modulated, of 
course, by its condition; health, sickness, power and weakness, either 
mentally or bodily. 

We can see, hear or feel for ourselves, or we may read or be told by 
others, that the organs cf sense teaches us the doings of the world, as 
well as the thoughts of other men. Thus we receive impressions in 
our brain, through our memories they become fixed and in coagita- 
tions are at our disposition. After mature deliberation we come to 
conclusions, which are in due time, and in accordance with our men- 
tal resolutions, executed by the different organs for that purpose. 
Thus we use our legs and feet in walking, running, etc. ; our hands in 
their avocations, and our mouths in moulding the sentiments of oth- 
ers, as well as proclaiming the results of our researcher, and our ears 
to listen to those who are our superiors mentally. 

We see our soul through the actions of the body in its daily avoca- 
tions in ourselves, and others, and the lesson thus learned enables men 
to rule among themselves and the earth. This is in fulfillment of the 
Creator's aims. 



THE SOUL. 33 

As a stranger, man comes with his body; yes, even in his body, into 
the world. The child learns gradually the use of his senses; learns 
to think, to walk and to speak. Our soul is not of this world, and 
we are unable to see it with our eyes or hear it with our ears or touch 
it with our hands, but into its worldy abode and its worldy work shop, 
we are permitted, through the scientific researches, to observe the 
mental activity or its reverse. 

In order to place the mechanism of the cerebral or brain functions 
within the reach of minds, which have not been prepared by special 
studies, the nervous system may be fittingly compared to electric tel- 
egraphy. 

As in the telegraph, all the dispatches, the impressions, arrive at the 
home office, the brain, by myriads of fibrils, afferent nervous fibres, which, 
irom all parts of the body, terminate in a common nervous center 
called optic layer, the arrival office of a telegraph system. 

From the optic layer proceed numerous afferent fibres, which place 
it in relation with the cortical cellules, the combination of which con- 
stitutes the external layer, the grey matter, and the active part of the 
brain. In these cellules the dispatch is analyzed and carried by com- 
missural fibres, the corpus callosum, into the hemisphere of the op- 
posite side. 

After this last test, perhaps a kind of superintendence, the dispatch 
is carried by different nervous fibres into the striated body of the 
brain, which might be termed the departure office of the telegraph 
system, from whence it is sent off to the organs in the form of the 
will by the motor fibres of the nerves. 

The result of the functions of nutrition, as superintended by the 
apparatus of sensation, leaves us now the consideration of the appa- 
ratus of locomotion. 

The faculty of moving depends on a general property, namely, 
contractility, which in man resides in the muscles, the whole of which, 
taken together, constitutes the flesh. 

These muscles are attached to the bones, which are connected by 
joints; as to their structure, location and names the reader is referred 
to their anotomical description and the illustrations upon the subject. 

In the foregoing lines we have learned how closely and intimately 
body and soul intermingle ; how we preceive the doings of the latter 
by the actions of the former. But still more visible signs exist, when 



34 CAUSES OF SICKNESS. 

we consider the inability of the body to conceal thoughts when they 
become apparent by change of color in his face. The red flushed cheeks 
of shame; the deadly palor of fright, are signs that our brain sends 
out dispatches which the body delivers under protest. 

The movements in a body are affected through passive apparatus, 
or the bones constituting the skeleton, and were it not the symbol of 
death to many, its wonderful mechanism might be studied to advantage. 
The coverings are the muscles, possessing the property of contraction 
and relaxation, more or less under the control of the will. So when 
the brain dictates a movement, word is sent by the nerve fibres to the 
muscles interested in the action, and thus obedient to the will the 
muscles either contract, flex, extend, abduct, etc., thus setting the 
passive apparatus, the bones, aided by the joints into motion. 

Having learned the structure of the different organs of the human 
body and the functions they have to perform, we naturally come to 
the conclusion, that, if we are born in health, what makes us sick. 

Accidents are isolated cases, taking cold or over exertions are oftener 
the cause, but surely the main source of illness is an unregulated 
mode of life, bad air and unhealthy food and drink, badly ventilated 
and damp houses, too much or too little clothing. 

What is a cold? The morbid state of the system produced by ex- 
posure to cold or dampness. The blood is evenly distributed in the 
respective blood vessels, and when a part of our anatomy is exposed 
to a change of temperature, caused either by a lower one or extreme 
dampness, the vessels through which the blood flows contract somewhat 
they become chilled and drive the blood from the surface towards the, 
internal parts, causing there a congestion, occasionally to such an ex- 
tent that haemorrhages ensue. More frequently the congestions are 
ameliorated through inflammation of the mucus membranes in the 
different parts of the body. Thus the blood driven to the glands, 
secretes the mucus which we throw off, after taking a cold. Cold 
in the eyes makes them watery and inflamed; in the nose, catarrh; 
in the mouth, a blistered mucus membrane ; in the throat and wind- 
pipe, catarrh and expectoration of mucus; in the lungs, of congestion 
of the capillaries, inflammation of same, and the secretion and ex- 
pectoration of the pus; in the digestive tube, catarrh of stomach and 
intestines, accompanied by diarrhoea. All colds are more or less 
accompanied by fever. 

How does an unregulated mode of life interefere with our health? 



COLDS. 35 

In the human organism a constant change is continually taking 
place even in the smallest particles; the particles gradually dying and 
being replaced by new ones, so that every organism bearing all out- 
ward signs and appearances of the former whole is after a certain 
time really composed of new materials, exactly resembling those, which 
having fulfilled their separate functions, die off, are discharged and 
replaced by new ones. Nov/, when this process goes on we enjoy 
health; disturbance of the same gives rise to different sicknesses. The 
digestive organs play a most important part in this process, whose 
function it is to form the chyle from the different articles of food 
taken into the stomach and to carry the same into the blood. Dis- 
turbances occurring in the functions of the digestive organs are, 
therefore, of the greatest importance, as they interfere and render 
abnormal the nutritive assimilation, causing disturbance to the gen- 
eral health, and laying the foundation to many sicknesses. There- 
fore, to keep in good health it is of the utmost importance that the 
digestive organs perform their functions in a regular manner. ■ 

One of the most frequent interruptions occurring in the process of 
digestion is sluggish stool, in which case the contents ot the intestines, 
which in a healthy subject are always expelled with ease, are retained or 
got rid of with difficulty and in small quantities. This unnatural col- 
lection and retention of excrement in the bowels, consisting mostly 
of decomposed food mixed with gall and mucus, can certainly be re- 
tained for long without causing any disturbance to the health ; but as 
a rule a very short time suffices to give rise to all sorts of disagreeable 
symptoms and soon lays the foundation of serious illnesses, some 
most difficult to cure and many proving fatal. 

The cause of all this lays mostly in partaking of unsuitable food 
and drink, matters which have shown us by experience as are hard to 
digest. To make a list of these foods and drinks, would be impos- 
sible; then it is a well known fact that one person can eat rich salads, 
wash them down with viuous or spiritous liquors any time of day or 
night, digest them, and feel no bad symptoms, while others would 
become, from such indiscretion, "sick unto death." It shows us that 
the first party is the possess or of a strong digestive apparatus, and the 
latter of a weak one. 

Eating when stomach is filled and "crowding" this organ will make 
serious disturbances. The taking of food at unseasonable hours and 
at irregular intervals has a like effect. To partake of more food than 



36 DIGESTION. 

is requisite for sustenance and too little for the regeneration of the 
blood, all have a tendency to throw the digestive organ out of order. 
The sedentary life to which the large mass of mankind is subjected is 
another cause, inasmuch as it causes constipation and other disturb- 
ances of these organs. The symptoms are generally in the disorgan- 
ization, that the patient gradually becomes aware of an unpleasant 
sensation, as if the stomach was overcharged or full of wind, com- 
bined with a tense feeling in the same region, the appetite declines, 
the tongue becomes furred and a bitter or sour taste often accompa- 
nied by a copious flow of saliva from the mouth, occurs. Other symp- 
toms of disturbed digestson are: Feeling of sickness, sour and rancid 
eructations, heartburn and troublesome feeling of pressure in the 
epigastrium. 

The patient complains of queer feelings in the head, dizziness and 
headache, which latter is confined to the forehead. When costive- 
ness continues for a long period, the consequences may become more 
and more serious ; the diaphragm is forced up against the thoracic 
viscera, causing a feeling of tightness in chest and a greater or less 
difficulty in breathing. 

Disturbances occur in certain abdominal blood-vessels, sluggish cir- 
culation sets up, giving rise in the first instances to rushes of blood to 
the head and chest (which accounts for the difficulty of breathing, 
palpitations of the heart, with feeling of anxiety, tight feeling across 
the chest, dizziness, etc., etc.). Through a longer continuance of this 
evil, the circulation of that wonderful network of bloodvessels, which, 
coming from the liver and spleen, surrounding the intestine, stomach 
and pancreas and called the "portal system of circulation,'" stagnates, 
causing congestion of liver and spleen with enlargement and organic 
changes; alterations of the gall both in quantity and quality, hemor- 
rhoidal affections, troubled frame of mind, and often apoplezy. 

You will ask how is it possible, that all these troubles can come 
from the disturbances in the digestive organs. We have learned that 
through the digestive organs, our blood becomes recuperated and in 
turn builds up again worn out particles of our organism. If the 
digestive system performs these duties in a regular manner, we need 
not fear any disturbances, but when disorganized and the lacteals, 
which absorb throughout the intestinal canal, chyle, the main blood 
building substances, and this is intermixed with excrementitious 
matter, which ought to have been eliminated from the system, but can 



KIDNEYS. 37 

not owing to these disturbances, then particles are carried into our 
blood which should not be there and cause, in consequence, disease in 
its various forms. 

We have learned that the urine is to the nutritive liquids what the 
excrements are to the solid ailments. 

All absorbed substances that have become, or are from the start, unfit 
for the nourishment of the body, must be cast off by the blood, that 
being the chief centre of nutritive assimilation, if the blood retains 
these unfit particles, its condition becomes bad and it can not perform 
the functions it owes the body. The duty of discharging or carrying 
away the refuse matter from the blood is performed : 1st, by the 
kidneys, 2d, by the lungs, 3d, by the liver and 4th, by the skin. The 
ingredients which these organs eliminate are as follows : 

The kidneys, filter the blood and sequestrate the urine and its 
constituent parts and lead this liquid out of the body. If we drink im- 
pure water, holding in suspense, or disolved in it deleterious substances 
the functions of the kidneys are interfered with. The partaking of 
two much water overworks the kidneys, and an insufficient quantity 
has a tendency to prevent the dissolution of the constituent parts of 
the urine and remains in the blood and body in consequence. Large 
quantities of alcoholic drink has a tendency to congest the bloodvessels 
of the kidney and may cause inflammation. 

The lungs. They eliminate from our blood the carbonic acid, by 
means of partaking oxygen they find in the air, thus expelling the for- 
mer. When our respiratory apparatus is interf erred with, as explained 
in preceding lines, by the digestive machinery, and breathing becomes 
difficult more carbonic acid is retained in the blood, than the body 
demands, asphyxia in its first stages will result, also fevers and con- 
gestions of the lungs are frequent ailments, aroused from the improper 
discharge of the carbonic acid. 

The liver. It secretes the bile from the blood. If from an over- 
flow of blood to this gland, it becomes congested, its functions are 
disabled and the blood retains the bile or gall, which leads to jaundice, 
and numerous other liver complaints. Further when the liver is in- 
capable of secreting the bile, it has none to furnish to the intestine and 
the absence of this important digestive fluid, causes numerous troubles 
in the digestive apparatus. 

The skin eliminates from the body fatty matters, as well as cools the 
body through its function of perspiration. Like everything else, its 



38 SKIN. 

wonderful machinery is worked by the blood, and when an impure 
blood is furnished for its functions, the closing of the sweat tubes, 
and sebaceous glands takes place and the excrements which find 
egress through this part of the body cannot be cast off and are retained 
in the blood and thus adding to its impurity. 

Thus it is, that, when through disturbances, these different excre- 
mentory organs become incapacitated to perform their functions, much 
of the refuse matter remains in the blood, and usually proves to be 
the germ of troublesome and dangerous diseases, such as skin erup- 
tions, gout, rheumatism, all the numerous affections of the lungs, 
liver and kidneys, hemorrhoids, open sores, etc., etc. 

Houses badly ventilated are very injurious to health. The air we 
exhale from the lungs is charged with carbonic acid. When this foul 
air finds no vent, we inhale the same again. Its poverty of oxygen the 
matter giving the invigorating power to our blood is missing, and the 
functions cannot be properly fulfilled. Damp houses are equally in- 
jurious for the reason that through the existence of moisture, decom- 
position takes place, causing gases to rise which we inhale to the injury 
of our well being. 

Too much clothing causes artificial perspiration and too little cloth- 
ing drives the blood towards the internal parts. 

Light is life. Everv farmer knows, or at least ought to know, that 
the vegetable kingdom in which he works, furnishes oxygen in day time 
and uses and absorbs carbonic acid, while during the night the reverse 
takes place. 

The two divisions, animal and vegetable, are closely allied, and 
even if the change is not as marked in the former, as in the latter, 
we all know that young children, deprived of the light of the sun, 
are weaklings throughout life. 

The occupation of man and woman must be congenial to their 
living in order to enjoy health. We all must work, either physical or 
mental, if we do not wish to violate the old saying, "who does not work 
must not eat," and is it not true that our daily bread tastes sweeter 
after a good day's work. The reason for this is that through our ex- 
ertions, in whatever direction they may be, part of the blood in our 
bodies has been consumed and must be replenished through healthy 
food. 

If we violate any of the laws of nature in regard to ourselves, we 



LAWS OF NATURE. 39 

have to suffer. All the fervent pleas we may offer, that we did not 
know or thought it would not harm us, are no bar to the consequences. 
But before we suffer the final, and cross to the unknown, a chance is 
given us, which may obviate and extend the time for dissolution of 
body and soul. This lies in the numerous remedies, from the animal, 
vegetable and mineral kingdoms, which nature has provided and 
science shows us how to use, in combating the many, many diseases 
to which our bodies are subjected. 

To administer these remedies intelligently requires a knowledge of 
the human body and its functions, we trust, therefore, that you will 
study carefully the preceding pages; not alone, for the benefit of 
yourself, but also for the amelioration of the suffering of your fellow 
men. 



INVESTIGATION ANL OBSEKVATION OF THE SICK 

IN health the body regulates itself. To be in health means only, 
not to be aware of the existence of the material body, and to 
have at our disposition the mental power requisite in our thoughts 
and actions. 

Through heat water forms into stream, through cold into ice. "The 
action of moisture of acids on iron will oxidize same. In our bodies 
we have, likewise a constant formation and disintregation of its mate- 
rial component parts. Certain laws rule our course of life, birth, 
physical and mental development, and death. This course of life is 
not variable, only certain conditions can prolong it. Between life and 
death are health and disease. Health makes life a source of joy and 
disease the reverse. We have learned what a healthy body is and 
now let us likewise acquire a knowledge of the different diseases, 
their causes, their prevention and treatment. 

The Physician. This book does not pretend to give you means to 
control all diseases the human body is subject to, it would be folly. 
In fact it would be a crime, if you wait to call in the physician before 
a disease becomes uncontrolable through the means herein given. 
But this work will prevent the majority of diseases, if thoroughly 
studied and the remedies through it, at your disposal are administered. 
A man who has made a life time study of the science of medicine, has 
more remedies at hand, than we can possibly put at your disposal in 
this work and accompaniment. 

Therefore we cannot too strongly urge, in cases of obnoxious dis- 
eases to call in a physician, and if he, with His will then fails to 
remedy, your loss will be easier and you will not have the pangs of con- 
science, that you had not done your duty towards those near and dear to 
you. And when the physician takes charge of your sick, follow his 
instructions, without questioning, otherwise his labor would be for 
naught. 



SIGNS OF SICKNESS. 41 

What ails the sick? If you do not know already, learn all you can 
from preceding pages about the construction and functions of the 
body. That part, where pain exists is diseased, look then under the 
diseases of that class and compare carefully the given symptoms. 
Should then the complaints of your sick and your own observations be 
the same, you have the key to the situation at your command, ct in 
accordance with the advice given. 

Signs of Sickness. We have learned to judge the body when in health. 
How the same will act and perform the duties of life. If any part of 
the human organism shows a laxity in the performance of its functions, 
it is surely a sign of approaching indisposition, disease, or may be 
death. Act at the first sign, then for the last no remedies exist. 

Age and Sex. Have much to do with determining the cause of sick_ 
ness. So in the young, when growth, and consequent changes, are 
more rapid, disease is more liable to appear and vanish, than in the 
mature body. Sex also influences life to such extent, that a complete 
revolution takes place in the female at the time of puberty. The aged, 
sometimes through loss of teeth, and other causes, cannot assimilate 
their food satisfactorily, and the changes being more slow, the ap. 
paratus of nutrition needs looking after before it is too late. 

The Complaints of the Sick. Watch them carefully, whether they are 
generally indisposed, with no particular seat or location, or whether 
their mind is disturbed, look into the cause of such disturbance and try 
to convince them of their temporary nature. Listen patiently to what 
your sick have to say, do not make small of their complaint, but 
gather all facts, discard all fancies and hallucinations, and establish 
in the sick the confidence, that their troubles are yours also, — make 
from all this a careful diagnosis and apply the remedies now at your 
command. 

The Constitution. Whether strong or weak. In the former some 
irregularities are easily remedied by simple means, but in the latter 
greater care must be exercised and the best we can do for them is a 
very nourishing diet to make them stronger. Excitability, shows 
a poor nervous constitution. A bilious constitution requires frequent 
cleansing of the alimentary canal, and shows itself through constipa- 
tion, digestive troubles, yellow skin, dark urine wind in abdomen, 
and coated tongue. 

A constitution subject to pulmonary consumption, shows itself in a 
long thin neck, thin, long growth of body, narrow chest, wing-shaped 



42 FAMILY PECULIARITIES. 

projecting shoulder blades, a very white, thin, soft and transparent 
skin, showing the "veins, quick pulse, a hectic flush in cheeks, warm 
hands after eating, short of breath. Also constant tendency to 
catarrh in the respiratory organs, pneumonia and haemorrhages of the 
lungs. 

A constitution which shows a tendency to apoplexy is usually 
marked by a large head, short, thick neck, broad shoulders, heavy 
trunk, corpulency, red eyes and face. 

Habits will sometimes become a second nature to ourselves, and fre- 
quently to such extent that they are the causes of numerous diseases. 
Let us enumerate: Drinking alcoholic and malt beverages to excess, 
smoking, living on an exclusive diet without variation. Further a 
poor man becomes rich, changes his mode of life, by eating and drink- 
ing only the richest foods, his constitution becomes undermined, and 
his foundation is weakened if not entirely destroyed by gout and other 
kindred diseases. 

Family Peculiarities of the sick, give us much information, as through 
it we may trace hereditary diseases. A plain bronchial catarrh in a 
person whose family is subject to consumption, is a far more agravated 
disease, than in a person, where the consumption does not run in the 
family. 

The law of heredity is too well established and known to require 
angr elaboration, for we see in persons around us and with whom we 
are acquainted, such unmistakable signs of its existence. Weak 
chested parents will transfer this faulty structure to their offspring. 
Fathers, who have not had the warnings of their parents, and having 
committed an indiscreet act with a diseased woman in their "wild-oats" 
time, and, thereby, contracted a loathsome disease, and which is too 
hard rooted in them, notwithstanding the ulterior cure, can transmit 
to their offspring scrofulous troubles and general disability. Many 
male troubles, and for that matter female diseases of the generative 
organs, prevent conception, others are causes of still birth, but lo, 
too often the little child, resting in the womb, partakes of the germ of 
disease, while part of the mother, and arrives in this world with a 
frail body, in which its soul finds a poor mansion. 

The cause of sickness. Only through experience and observation, 
and by the use of a clear mental conception can we prove the causes. 
Then by obviating the causes we can in future forestall sickness and 
by ameliorating the consequent condition we can cure the disease. 



INFLAMMATION. 43 

Inflammation. Origin and course. If we prick ourselves with a pin 
or other sharp instrument, are bitten by insects, come in contact with 
acids, burn ourselves by contact with hot objects, the blood-vessels be- 
come enlarged, first the arteries, then the capillaries, and lastly the 
veins. The blood flows quickly into the widened parts, but after a 
short space of time this flow slackens. The blood corpuscles are 
pushed together, like people before a house where a mishap has taken 
place. The little globules assume a wave-like motion, and in thi s 
part of the anatomy the circulation of the blood is upset. Then the 
blood secrets an albuminous, coagulable mass, which moistens the 
damaged cells, which leads to suppuration. The signs of inflam- 
mation in all parts of our bodies are unmistakable, for we feel them 
through the nerves, distributed to all parts of the body. 

Where the usual signs of inflammation manifest themselves, either 
through red appearance, heat, swelling, pain, as other signs in the 
interference of the cells or their obliteration is the seat of the inflam- 
mation. Sharp boundaries do not exist, however, the course may be 
towards the internal parts or may spread on the surface, while we are 
cogitating, how the inflammation occurred and from what cause. 

If the inflammation comes to suppuration and deposits pus it should 
be carefully removed and the wound be kept strictly clean. If the pus 
does not leave the body it will act as a seed and spread the inflam- 
mation to other and adjacent parts. 

To allow inflammatory sores to spread has very often disagreeable 
and sometimes fatal consequences, it spreads with rapidity and shows 
itself in numerous types. They will mostly show in fatty parts, bone 
projections, muscular enlargements and cancers. If poultices will not 
do the work to bring them to an early suppuration the aid of the sur- 
geon's knife has to be resorted to. Even a guarantee for a complete 
cure in these cases can not be given, but a prolongation of life can be 
counted upon. 

In case inflammatory swelling occurs to stomach, womb, breast* 
tongue and lips, these parts should receive the utmost care and atten- 
tion, so that relief from disease is had as early as possible. 

The process of the formation of inflammatory swelling is rather a 
gradual one in the beginning and perhaps not even noticed at first. 
We naturally ask, when does the period of danger commence? When- 
ever a part of the body, becomes through this ailment incapacitated 
and cannot fulfill its functions, and causes us uncomfortable feeling — 



44 CAUSES OF INFLAMMATION. 

yes even pain, then it is sick and aid must be at hand. For in the 
first stages we can counteract the disease easier, than at a period, 
when it is of greater scope. Always remember that we cause our 
bodies, undesirable feeling and even sickness by our own acts, as well 
as by our neglect to act at a proper time. 

Inside of certain boundaries our bodies regulate themselves, but 
you may take it for granted, that this boundary is as small as the 
paradise upon earth. The body needs always the aid of the soul and 
mental faculties to be kept in good health. 

When any part of the body, either in mixture or build, becomes dis- 
organized, it has always a direct cause for such. In order to become 
acquainted with the causes, let us investigate these, by observation on 
such parts as we can see. Slight mechanical causes, such as pressure, 
fricture and contact with harder substances are usually relieved by the 
elasticity of the skin. Still greater is the protection of hair and nails. 
Frequent friction of the skin tissues will have a tendency of hardening 
same as the thick skin in the hand of a laborer, or the corns and 
bunions on feet of people, who insist that a number " 6 " shoe will fit 
their number " 9«" foot. Stronger mechanical power leads to rupture 
of the blood-vessels, bruising of muscles and the periosteum or bone 
skin, sprains of joints and fracture of bones. All these may occur 
from this cause, leading to inflammation without rupturing the skin. 

Strong heat and cold, as well as quick changes between them, are 
well known thermal causes for inflammation. 

Strong concussions, for instance, of artillery and blasting may 
cause rupture of the tympanum or drumskin of the ear and its inflam- 
mation. 

Too strong light will cause inflammation of the eyes. 

Chemical causes of inflammation are acids coming in contacts with 
the internal or external tissues, Lye and unslacked lime have similar 
properties. 

The bite of the poisonous snake cause inflammation hard to control. 

A great many internal diseases are caused by inflammation from 
some cause, mostly by the inhalation of the germ of the particular ail- 
ment, but also from thermal causes. 

Bronchitis, or inflammation of the air passages, Catarrh of the nose 
or inflammation of the mucus membrane, Diphtheritis or inflamma- 
tion of the tonsils, Inflammation of the mucus membrane of the 



CHANGE IN NUTRIMENT. 45 

digestive tubes, such as gastritis, catarrh of stomach and intestine, 
flux, typhus and cholera. Of the Generative organs may be mentioned 
Childbed fever. 

The nerves give life to the tissues and the blood is the means of life. 
They become exited when they move the tissues to activity. When 
our will wants work from our muscles the nerves deliver the message 
and the sympathetic nerves take care that sufficient of the nutrient 
blood is supplied to the active parts. When we are very cold or hot, 
we notice that our nerves are occupied in preventing a too certain 
change and also appeal to our mental faculty for assistance. We 
better respond, if not, we pay for our carelessness and ignorance 
usually, through the painful incidents of the sick bed, yes, often worse, 
death. 

Many professional men, scientists, and people in general who work 
with their brain, have been unable to take along the honor and fruit 
of their labor into the insane asylum. Their mental exertions strained 
their brain and they misjudged its capacity. Never thinking that this 
part of their anatomy needed food and rest proportionate to the work 
asked from this organ. What are the consequences*? Inflammation 
and softening of the brain, kills first his mental faculties and incapaci- 
tates the brain from reigning over the body till such time, the latter is 
also useless, when death becomes a welcome visitor. 

The finger muscles of the violin player and the muscles of the 
larynx in a singer are often put to terrible strains, even to such extent 
that they refuse the bidding of the soul. Thus a God given talent is 
ruined by a misguided will. 

Thus we can strain most every part of our bodies, the consequences 
of which show their first symptoms in inflammation. 

Change in nutriment and consequent condition are not bounded and 
calculable solely by the increase and decrease of the body, but single 
tissues are to be considered, of which the body is composed. The 
difference, whether these single tissues need albuminous, fatty or 
glucose matter, or any of the salt, water, oxygen, or if any of these 
substances are accumulating, shows very plainly in the beginning of 
the downgrade in sickness. Hunger has different consequences as 
thirst or the want of oxygen, not only when the patient feels 
it, but also when the careful nurse observes. The organs, desir- 
ous of being appeased in hunger, thirst or respiration, should be 
satisfied moderately, for in their diseased condition, they cannot di- 
gest them to the full extent as in health. 



46 TEMPERATUEE OF THE BODY. 

Starvation. If the body does not receive any nutriment it will con- 
tinue to exist from 8 to 12 days, and this may be extended by the 
administration of water even to 40 days. The daily loss of muscular 
tissue and in weight of body is considerable at the beginning, but as 
a diseased body is liable to take part in little activities, this loss re- 
laxes. Children suffer an earlier death by starvation than grown 
people, because the changes taking place in their organism are of a 
livelier nature. The substances which vanish from the body 
are first water, then fat. 

Temperature of the body can lower from 98J ° in health and rise in 
extreme cases to 109 ° or even 110 ° which, however, usually ends in 
death. The variations of the temperature amount in some diseases 
to 20 ° , but such extreme cases usually brood no good for the patient. 

The lowering of the temperature is caused by the want of nutriment 
and oxygen, but also by changes in the circulation of the blood, and 
by inactivity of the organs. It is for this reason that aged peo- 
ple suffer more from cold than the younger and active ones and that 
we make use of bed covering during sleep, where all organs rest, ex- 
cept the heart, lungs and kidneys. 

The use of bodily temperature is not only caused by acitivity and 
contact with heats, but also through disharmonization of the condi- 
tions of life, such as the changes taking place in the organism. If 
this goes on regularly we feel well, but if the changes in our body 
becomes disorganized, a quick change of temperature takes place and 
if towards the upper scale of the thermometer, will constitute fever. 

It is from the localization where the origin in temperature causes 
changes that we name the different fevers, such as gastric, (stomach) 
brain, rheumatic, gall, hectic, etc., and owing to the regular recurring 
fever we have the disagreeable ''intermittent." 

Fever is a sign of over heating of the body and usually the accom- 
panying symptoms of numerous maladies, and through which, ac- 
cording to its strength, duration and change, sickness can be more or 
less controlled. 

Origin of fever. It is the over heating of any of the tissues, without 
being able to give proper ventilation of the same and which may lead 
to inflammation. 

The surest signs of fever is the rising of the temperature of the 
body. The rapid exhalation of carbonic acid, and the increase in 
urine with sediment of a dark nature in bottom of vessel are also 



FEVER. 47 

signs. After the heat finds vent through the skin, perspiration sets 
in, and with it is lost quantities of moisture and salts, all tending to 
weaken the whole system. All the organs requisite in the preser- 
vation of the body are in feverish activity to make up for the loss, and 
so it comes that the portions necessary for our mental faculties are 
badly neglected and delirious moments may ensue after a fever, or 
during its period. Strong feelings of illness troubles the mind of the 
fever paiient and the proper place for him is the bed ; sharp light, loud 
and continued conversation, bad smells, contact with cold substances 
are painful to him. The patient is not capable to formulate a thought. 
The nerves, through the great strain they have undergone, are very 
sensitive. He has flickering before his eyes and a queer noise in his 
ears. His head is in pain and ideas run races through his sick brain, 
which his mental faculties find laborious to control. Towards evening 
it is frequent that delirium sets in and it is of frequent occurrence 
that patients jump out of the bed and sometimes out of the window, 
when not carefully guarded. In such cases ice poultices or cold wet 
cloth on the head will tranquilize the patient and convince us then 
that the seat of fever is in the brain, where these mental disturbances 
had their origin. When the fever becomes so strong that the temper- 
ature rises in the neighborhood of 109 ° the ' contents of the tissues 
become disorganized and in many of the organs a fatty degeneration 
takes place. Blood will coagulate at 110 ° in the veins. 

The patient has no appetite, in many cases, an aversion against the 
most tempting food; his digestive organs are passive, tongue and lips 
are dry, the former usually coated with a whitish yellow mass; the 
inactivity of the intestine leads to constipation and an unquenchable 
thirst tribulates the patient, notwithstanding he takes large portions 
of drink. 

Fever leaves temporary tracks in a patient's appearance and 
strength. Their recuperation requires careful nursing and a gradual 
tax of the organs is only permissible. 

The acts of walking and sleeping are two conditions of the body, 
which in its disease must be carefully observed. The life during the 
day belongs to the mental and that during night to the physical part of 
the human organism and on its regularity depend greatly these funct- 
ions. These conditions are greatly changed through sickness, howev- 
er; then we find in certain diseases "insomnia," or unable to sleep 
and in others where the body is in a comatose . condition or state, 



48 GENERAL SIGNS OF DISEASE. 

resembling a drowsiness from which the patient has had to awaken. 
These two conditions are pretty sure signs of illness, in the first it 
shows a great irritability of nerves, or that, owing to the strain the 
nerves have undergone, their excitement cannot be tranquilized by 
profierred sleep. Comatose condition shows something in the nature 
of a collapse of the nervous system, an exhaustion, and its degree of 
danger is measured by the amount of means it takes to bring the 
patient out of lethargy. 

The sleep needs careful observance on part of the nurse ; whether 
troubled by dreams, or whether acts take place in the patient, such as 
drawing of faces, gesticulating, speaking and movement of the body. 
In a state of health these symptoms will not show themselves, and 
hence, are sure signs that the mental machinery of the body is at 
work, and that the patient does not receive the rest and refreshment 
his ill body so badly needs. 

Noise in the room or neighborhood, penetration of natural or arti- 
ficial light, uncomfortable beds, irregular and badly prepared meals, 
too much bodily exertion, are all causes, which keep the mental facul- 
ties in action, even when the body is completely exhausted, and 
prevent the sleep of a sick man. The respiration of the patient needs 
watching as to its regularity and also whether the pulse beats 
normally. 

General signs of disease can, therefore, be diagnosed: 

1st. Through heridity. 

2d. Through loss of power. 

3d. Through non-assimilation. 

4th. Through temperature. 

5th. Through insomina and its reverse. 

The time in which we can make observations, however, is very 
variable; we may notice the change in a minute, it may take us an 
hour, a week; yes, even months before we come to a conclusive reali- 
zation of the condition of our patients. So in watching during long 
periods, we notice how well disease takes root in the body, too often t 
we cannot check its growth, as for instance in consumption. 

None of the different apparatus making up the human body must 
be overlooked. We may detect our enemies in their layer, least ex- 
pected, and it is like warfare, in taking advantage of the enemy when 
he is not watching you. 



ORGANS OF NUTRITION. 49 

The organs of nutrition assist us greatly in locating and determining 
the course of disease. 

Appetite and a clear well denned taste for food are good signs of 
health and the loss of these surely means mischief. When the haby 
finds difficulty in taking its natural food you may be sure, that its 
nasal passages are obstructed and has to breath through his mouth, by 
which air enters into its little stomach and which, besides catarrh in 
nose, give the little one wind colic and disorganization of the organs 
of digestion. Through the catarrh, inflammation of the mucous mem- 
brane of the nose will insue, the mucus, if not removed, will descend 
from the little nostrils to the upper lips causing inflammation of the 
tender skin causing roughness in same. Thus through carelessness 
we sow the first seeds of scrofula in children. Similarly will inflam- 
mation of the cavity of the mouth act, only that its consequences are 
more troublesome. 

If we have trouble in swallowing food, it shows that the mucous 
membrane of the mouth and gullet are diseased and need attention. 

The tasting of food after it has entered the stomach shows that that 
part of the digestive apparattus is out of order, The accumulation of 
wind proved that disintregation of food and forming of gases takes 
place without a sufficient assimilation. Vomiting, especially in babies, 
when the milk is not curdled, is a sure sign that the stomach emits 
insufficient quantities of gastric juices, otherwise the process of fer- 
mentation would have taken place. Mistakes in diet are usually 
relieved by vomiting, but this operation is weakening to the muscles 
of the stomach and frequent mistakes show evil signs, and the most- 
terrible of these is the stomach of the drinker. Instead of the read 
color of the stomache in health, its aspect is of a slaty grey, with 
expanded blood vessels without elasticity and weak in structure. It 
is always shrunk, this owing to the scarcity of food which entered into 
it. Often we find the residue of ulcerations and inflammations which 
in time would have become ulcers, had not the weakened condition 
been unable, to prevent death, of a life badly spent. Nervous pains 
in the stomach are often accompaniments of other illness, especially 
in the female generative organs. They show themselves nearly at 
every period and the vomiting after conception may be considered a 
sure sign of approaching motherhood. They serve to notify the 
young wife that she has been blessed and that she may prepare for 
her most honorable calling, mother, by a proper diet and clothing and 



50 MOTHERHOOD. 

manner of living in general. If she violates these rigid laws of 
nature, not only the offspring, which from now on will carry for about 
nine months under her womanly heart, will suffer throughout its 
worldly Lfe for her indiscretion, but also herself will partake of the 
the punishment nature bestows. 

If we follow the tract of the nutritive organs into the intestine ; 
first, the duodenum, we find that badly digested ailments in it 
A have a tendency to cause inflammation similar to that which takes place 
n the stomach. When we vomit, and find in the excluded mass, either by 
bservation or smell, the existence of bile, itshows that the intestine is in a 
diseased condition. Then it is in the duodeum that the bile is delivered 
which in health has only an excretory tendency ;if the mucous membrane 
of the intestine becomes inflamed it closes, by means of swelling the com- 
mon duct which delivers the bile. This substance being needful in 
digestion, these functions so necessary to life become lamed. On the 
other hand, our blood, from which the bile is secreted, has no canal 
left by which it can be eliminated, so it must remain in the blood and 
thus it is that we have billious attacks, billious fever, congestion of 
the liver, and a number of other disagreeable diseases. The signs 
are usually a yellow skin, dark rings around eyes, irritability of tem- 
per, cold feet, dark urine and a general bad feeling. Other ailments 
of the intestine are caused by constipation, telescoping of intestine, 
twisting and hernia, which, however, will be more fully described 
under the treatments of the specific diseases. All of these conditions, 
however, have a tendency towards inflammation of the mucous mem- 
brane of the intestine. How the interference in the digestive tube 
causes and acts upon a sick body, shows us the appetite in the shape 
of hunger, then it is an even thing, whether our body receives nutri- 
ment, or whether that we place in it is not digested. 

The respiratory organs require pure, not too dry air, for inhalation 
and a sufficient exhalation of the carbonic acid. This is the only 
true and reliable remedy against consumption, and where we can find 
these atmospheric conditions, that is the place for consumptives to 
live. 

Mouth and nose are the portals through which air enters and leaves 
our body. The inhalation through the last mentioned organ is pre- 
ferrable, as it becomes tempered in its nasal canal and becomes re- 
lieved of many impurities. The respiration through the mouth has 
disadvantages, inasmuch as cold air is uncomfortable to the teeth, 



EESPIRATION. 51 

dry air absorbs too much moisture from the mouth and causes a 
parched feeling to the mouth. As a general respiratory organ the 
mouth should only be used in speech and song. 

Exclusive respiration through the mouth is a sign of disease and 
shows that the air passing through the nose irritates the membrane 
or that its passages have become contracted through inflammation, or 
that the catarrh has clogged up the passages. So that while 
naturally breathing through our nose, in case of indisposition of that 
organ, we resort exclusively to the mouth for our air. 

Breathing through mouth alone leads to many diseases and show 
themselves by a parched, cracked tongue, and thirst which is 
hard to quench. It is dangerous and may lead to inflammation of 
the layrnx and whole respiratory tract and causes the expectoration of 
large quantities of mucus. 

Breathing through mouth also causes snoring and blowing during 
sleep, so disagreeable to others in the same bedroom. The best 
remedy for snoring is to turn the sleeper over, or to transfer him to a 
bed which contains no feathers or soft substance to lie on. 

Sneezing is a sign, remote, however, of an approaching indisposition 
and we may take it, as a warning, that the air we inhale is exciting to 
the membrane of the nose. Impurity, heat, cold and dryness in air are 
causes which induce sneezing. 

In health, the catarrhal substances we remove from our nose, by 
means of handkerchief, are protectors to the nasal membranes, 
in as much as to it adhere a great many particles, which otherwise 
would pass in to the air tubes. But in disease this catarrhal mass 
contains also the product of inflammation along the tract of the 
mucous membrane lining the nose and should not be allowed to come in 
contact with other part of the mucous membrane of the body, as 
by it, a similar inflammation can be transplanted. 

Thus it comes that catarrh of the nose is transferred to the cavities 
of the mouth and windpipe, and also to the outer poition of the lips. 
By swallowing some of this catarrhal mass, it may cause trouble in the 
stomach. It occurs for instance, when we have catarrh, only slightly, 
and when asleep the mass accumulates in back of mouth and unbe- 
known to ourselves swallow it. So when on next day we feel mean 
in stomach, we imagine that another ailment has made its appearance 
and of a different nature. 

The same occurrences will take place when we have bleeding from 



52 DISEASES OF THE LARYNX. 

the nose, and its entrance from the pharynx into the air tubes or 
stomach during sleep. By coughing in the morning, and the expector- 
ated mass contains little particles of blood, we imagine weak lungs> 
or vomiting blood from the stomach, we come to the conclusion that 
ulcerations in that organ takes place. All these fears come from 
simple ignorance and no guide to investigate the caus«. If not chronic 
and excessive, a little bleeding from the nose is no cause for alarm 
whatever, it only shows that irritation has taken place, or that our 
hearts are a little too liberal in the distribution of blood to that organ. 

Sometimes we find obstructions in the nasal passages, which are 
caused by children in their play, to place foreign matter in to these 
cavities, and which become fastened through the inflammatory swel- 
ling of the mucous membrane. Growths of a disagreeable nature 
often obliterate the nasal passages, but usually only one at a time. 

The sense of smell is usually gone in catarrh. In nervous trouble s 
this can occur also, even to such an extent that this sense is entirely 
obliterated. The former is only of a temporary, while the latter 
troubles have been known to remain through life. 

Nasal diseases, by some unknown preference, have a tendency to 
transplant themselves upon the larynx, and vice versa, and not upon 
the tonsils. Consequently the existence of catarrh speaks for the non- 
existence of diphtheritis. It transfers itself often, however, to the 
eyelids, thus we notice our tears running in severe catarrh, or to our 
internal ear, causing slight deafness, it having found its way through 
the Eustachian tube, the connection between mouth and ear. 

Diseases of the larynx usually manifest themselves by speech and 
breathing. The voice loses its clearness, becomes hoarse, without 
further signs of disease, such as cough, expectoration, pain caused by 
illness of the surrounding nerves and muscles. These latter show 
themselves very rapidly, even in a malignant form and become hard 
to cure. The first symptoms should receive careful attention. 

Trouble in inhalations and exhalation, often accompanied by a 
piping noise, caused by laxity or paralysis of the vocal cords or swel- 
ling of the larynx, often turn out fatally. The latter is usually ac- 
companied by the growth of a membrane over the entrance to the wind- 
pipe. 

With children it happens frequently, and mostly a little after mid- 
night, that they awaken with an ill sounding cough, accompanied by a 
short breath, actually gasping for air. These symptoms are nothing 



COUGH. 53 

but a plain catarrh of the larynx, but are usually taken for an attack 
of croup. The parents are scared and in their anxiety send for the 
doctor, but before he arrives the child is soundly asleep, having 
losened the phlegm through coughing, and instead of expectorating 
same has swallowed the mass* 

Cough is caused through exited places along the air passages and 
the action of the nerves thereon. Also by careless eating, by getting 
of food particles into the windpipe. Inflammation of the windpipe cause 
a tickling sensation and induces coughing. The patient can be relieved 
of a great deal of coughing by keeping the air evenly tempered and 
slightly moist. The nurse must also prevent unnecessary excitement, 
calls of gossiping acquaintances and neighbors ; exertions through sit- 
ting or standing postures. The acuteness of the cough is best watched 
while the patient is asleep, for during this period nothing but the 
natural causes would be the inducement. 

Phlegm, so far as it originates in the respiratory apparatus has a 
tendency to irritate the mucous membrane of the same, and in conse- 
quence causes the cough. This is in a majority of cases the cause of 
coughing. The quantity of phlegm expectorated is very variable and 
depends upon the nature of the disease. Bleeding from the respiratory 
apparatus leaves very little doubt as to its origin, when the blood is of 
a red, foamy qualify and caused through coughing. It is instinctive 
to the patient to judge its source, owing to the sweet sickening taste 
and odor of the blood. It is the exception that these hemorrhages 
from the lungs are fatal in their first appearance, but they have a very 
depressing tendency upon the patient. Care should be exercised by 
the nurse, not to excite the sick in this stage, as relapses are of fre- 
quent occurrences and often fatal. Courage should be instilled into 
the sufferer, by word, that it is of no danger and only a passing inci- 
dent in his sickness; the trained mother or nurse, will not even show 
anxiety on her face or in her action, and by it contribute to the allevi- 
ation of stress in the patient. 

The respiratory movements in an adult healthy being follow each 
other for the most part with great regularity, at the rate of twenty 
inspirations per minute. This rate varies, however, under different 
conditions, one of the most important of which is age. As a rule, 
respiration is more rapid in children than in adults, and the standard 
rapidity is usually reached at the age of 15 to 20 years. Difference in 
posture also changes, so it has been observed that one person, while 
lying down, 19 respirations per minute were counted, and 22 



54 RESPIRATION. 

while standing. Any special muscular activity, such as walking Or 
running will also increase respiration, but come back to its normal 
state again, as soon as the exertion has ceased. In old age it dimi- 
nishes considerable. 

In disease respiration usually increases and especially so in fever, 
the tight lacing of females has a similar effect. The same takes place 
when we overload our stomachs, by accumulation of gases in the 
abdomen. But the strongest increase will be -noticed in 
diseases of the larynx and lungs and in undue excitations 
of the nerves. In abnormal mixture with our blood of spirituous 
drink, strong coffee aed tea will also facilitate the increase in breathing. 

Irregularity in breathing, as to pauses between inhalation and ex- 
halation are mostly noticeable in nervous complaints. 

The digestive apparatus offers only to the body nutriment at certain 
intervals. The tissues of the body have a storage capacity, from the 
contents of which the body can draw, thus our fat is only a reserve 
for the body to fall back on, and even the muscles will be used for 
the same purpose. But a faulty respiration will soon lead to a 
scarcity of oxygen in the body and a surplus of carbonic acid, under 
which condition the body will invariably suffer. 

The vague feeling in head, laxity of body, the pale color in face, 
contrasted by the hectic flush and bluish lips are unmistakable signs 
of irregular changes in the gases used by the blood and are forerunners 
of diseases which have their seat in the respiratory apparatus. 

The Blood and its Circulation. The signs of disease, which give us 
information, in regard to it, are liable to manifest themselves all 
over the body; then all the organs with which the blood comes in con- 
tact are liable to be affected. 

The color of the skin and the visible mucous membrane are 
of great importance in determining the condition of the blood. Do 
we not know with what rapidity this life nutrient acts upon these 
organs by observing the changes in their aspect? The quick changes 
in the healthy flesh tint and the red of the lips are evidences of the 
influence of the blood, when we notice the palor of the face, when one 
becomes scared, the red, caused by the rush of the blood to the face in 
shame and excitement and the bluish tint on our lips in anger. It 
shows the different distributions of the blood in these stages. In severe 
losses of blood we will also notice the waxy appearance caused by the 
absence of the colored fluid in the respective organs. The absolute 



DISEASES OF THE BLOOD. 5B 

quantity of blood remains a. stationery one in the body and even in 
loss, its quantity is replenished by the moisture existing in the body, 
which, however, does not assist in its nutrient qualities. In inflam- 
matory or other swellings blood in larger quantities exists in the 
affected regions, hence the taunt condition of the skin. The reverse 
occurs when there is a scarcity of blood and the parts will be relaxed 
and shrunken to the touch. These rules are applicable to all parts of 
the body, the internal as well as the external organs. The organs 
mose affected, however, are those most distant from the heart, as by 
the distance it has to travel to these outlaying regions, power requisite 
in its distribution is lost to some extent. 

Causes of impoverished blood have a tendency to a chilly feeling 
and cold, and especially are the ears, nose, hands and feet affected. 
By the absence of sufficient blood to any of these, or other organs, the 
nerves become afflicted for want of nourishment, and become easily 
excitable and in this flighty condition, extreme temporary rushes of 
blood may be transported to the affected organs, and thus transferred, 
partakes of the chill or cold and transmits by these means a change in 
the temperature of the general circulation. The suction and expelling 
power of the heart are also affected by this condition, to such extent 
that the venous blood becomes lax and is not relieved of its carbonic 
acid, and through the affected respiratory organs, not sufficient oxygen 
is brought into the body to make the changes necessary in the condi- 
tion of the blood. The bluish appearance of parts of the body, 
subjected to cold is due, that the venous blood is not flowing with the 
required rapidity. Weakness of body will show itself in this condition 
by a cold clammy perspiration. Gasping for air shows that our blood 
corpuscles do not find sufficient oxygen in the lungs, causing the rapid 
beating of the heart and an anxious feeling. The accompanying 
irritability and excitement of the nerves causes unaccountable noise in 
in the ears, flickering before the eyes, general weakness of the organs 
of sense, twitching of the muscles, and even cramps, if the blood sup- 
plied to the brain is insufficiant in quantity and bad in quality. 

Regarding a surplus of blood in the body, let it suffice, that it is of rare 
occurrence and can happen, and only temporarily at that, immediately 
after a very full and rich meal of nutrient and easily digested victuals, 
by carefully measured use of stimulants and insufficient bodily 
exercise. The latter if taken will usually remedy the uncomfortable 
feeling incident to it. Under extraordinary conditions, a healthy 
body, sometimes succeeds to enrich his blood to such extent, that a 



56 CIRCULATION. 

scarcity of oxygen becomes apparent and in this way, one will become 
'fat, and the more of this a body accumulates, its functions become im- 
poverished, for the preservation of health and the performance of its 
duties. 

Thus when one tries to accumulate fat or bodily increase and forces 
himself, the appetite will become depraved and it will require conditions 
to excite it, the fatty degeneration of the digestive tube loses force and 
becomes inactive, the same will happen to the liver and cause an 
interference in its functions ; the heart under its load of fat becomes 
weaker every day, then it finds no extra nutriment for the additional 
load it carries and work it performs. The venous blood slackens in 
its course and consequently gives no push to the arterial or tissue 
building blood. The body in this condition wastes the nutrient quali- 
ties of the blood, by forcing the albuminous substances into the kid- 
neys and out of the body. The kidneys object also to this extra work 
and rebel; sickness ensues and you find them in gouty swellings and 
diseases of the kidneys and urinary organs are general. 

Prevention is always cheaper, so do not make a glutton of yourself, 
especially if you have a natural tendency to corpulency, but give your 
body physical work. 

Diseases of the circulation are usually founded upon the power of 
the propelling organ, the heart, or in contraction and expansion of 
the blood vessels (arteries, veins and capillaries). The signs are best 
observed by the pulse and the different organs, when a change in the 
supply of blood has taken place. The movements of the heart lead 
us also in diagnosis, in complaints of this character, but it takes a 
trained practitioner to observe it. 

The widening and contraction of the blood vessels are properly 
classed with the diseases of circulation. Among the causes we find 
chronic catarrh of the stomach and intestines, pains in the testicles 
and cramps in the calf of the leg. But the most disagreeable form of 
these diseases is what is commonly called dry or itching and bleed- 
ing piles or haemorrhoids, situated in the rectum. They are ex- 
tremely painful, and no relief in the natural course is afforded till 
they burst, by which, however, a wastage occurs of the nutrient fluid 
of the body, consequently weakness will ensue. 

The most important influencess in the circulation are the organic 
faulty constructions of the valves of the heart. This is very trouble- 
some at times, the specialist in diseases of this character may give 



DISEASES OF THE LYMPHATICS. 57 

temporary relief, but to insist that any one can create intricate 
parts of tbe body is all folly, and will only be believed by people who 
are very ignorant. 

Bleeding through wounds needs careful attention, may they be ever 
so small, every drop of blood wasted is the loss of so much 
power. 

Inflammatory ulcerations in the lungs may cause hemorrhages and 
it will be noticed by the phlegm expectorated. Similar troubles may 
occur in the stomach or intestine and will make itself known through 
the blood. If the kidneys are thus affected we find blood in the 
urine. Also the ulceration of the ureter, bladder and urethra, notify 
us by the same excrement. Typhoid fever consists of intestinal ulcer- 
ation. 

The symptoms of diseases connected with the Lymphatic system are 
best and can oftner be observed by wounds of the skin, be 
they ever so small, and not kept strictly clean and disinfected. The 
placing of sticking plasters on open wounds is a great mistake and 
often revenges itself upon the transgressor. The pus is mainly the 
cause of supperation, and while in this condition the weaving together 
of the tissues cannot take place. It must, in view of this fact, have 
free exit from the wound before we can think of healing, The plaster 
would prevent the discharge of the pus and it would necessarily retro- 
grade and seek an opening at a different place, The careless paring 
of corns and bunions, as well as chafing of badly fitting footwear, lead 
often, to inflammation of the lymphatics. If you wash your feet night- 
ly instead of weekly or fortnightly, there is little danger of this disease. 
Think for a moment how many resort to this inexpensive healthful 
water every night. 

What we observe in the supperation of the skin, we may also find in 
the inflammation of the mucous membrane Inflammation of the 
eyelids, the tympanum, nose, tonsils of the neck, all lead to the 
swelling of the lymphatic glands and ducts, spreading very rapidly. 
The fatty layer under the skin is especially a conductor of this disease. 
Inflammation and suppuration of the muscles, also has a prediliction 
to lead to diseases of the lymphatics, and often carry it to the perios- 
teum and even the bone. In fact, inflammation in any of the soft 
parts of the body lead to lymphatic troubles. Very often the lym- 
phatic vessels suffer much from the poison they have absorbed, and 
when this has been conducted to the glands, the latter will enlarge 



58 EXCRETOKY ORGANS. 

very rapidly. The skin covering becomes red, the fatty tissues swell; 
one feels the accumulation of pus. Warm poultices should at once be 
applied, through which the pus is drawn to the surface, breaking the 
skin and leaving the body. In this stage the patient has often a strong 
fever. The inflammation of the glands connected with the generative 
organs are especially painful and troublesome and often are the cause 
of transmitting their poison to the whole system. Syphilis, scrofula, 
hydrophobia, glanders, all the different pocks are diseases having their 
origin in the disorganization of the lymphatic system. 

The signs of disease of the excretory ovgans we observe in two direc- 
tions. The quantity and nature of the excrementitious substances* 
They are formed for the most part in the tissues, from which they are 
absorbed by the blood and conveyed to excretory organs, by which 
they are discharged. If their elimination is impeded, their accumu- 
lation in the system produces disturbance, which is more or less, ac- 
cording to their character and the rapidity of their production. This 
disturbing influence is especially manifested in its action upon the 
nervous system, causing abnormal irritability, derangement of the 
senses, delirium, insensibility and death. 

In the normal condition and in normal quantities, the excrementi- 
tious matters are not poisonous, nor even deleterious; they are the 
natural products of functional activity, and therefore as essential to 
the manifestation of life as the nutritious material supplied by the 
food. It is only when the elimination is retarded that they interfere 
with the performance of the functions, by deranging the constitution 
of the tissues. 

Some of the excrementitious matters produced in the body are 
probably eliminated, in small proportion, with the perspiration or 
stool; carbonic acid is abundantly exhaled from the lungs. The most 
important of these substances are eliminated, however, from the body 
by the urine, of which they form the characteristic ingredients. 

The urine is, therefore, solely an excretion. It contains most of 
the mineral salts discharged from the body, and by the water which 
holds these matters in solution it represents a large proportion of the 
fluids passing through the system. Furthermore, accidental or ab- 
normal ingredients introduced into the blood are usually eliminated 
by the channel and appear as temporary ingredients of the urine. 
The constitution and variations of the urine during health, and its 
alteration in disease, are regulated by the corresponding changes of 



URINE. 59 

nutritition in the body at large. It is, therefore, one of the most 
essential products of the animal system, and its formation is second 
in importance only to the function of respiration. 

The urine excretion is often above the normal quantities, as in dia- 
betis and after hysterical cramps. The partial or complete non-elimin- 
ation lead to death. In fever the output is less, but increases as con- 
valescence progresses. In the beginning of inflammation of the 
kidneys it is very little, but the elimination becomes gradually normal 
again, when the inflammation becomes less and ceases. 

The color of urine varies much in disease and thus we find by ob- 
servation the following shades. Pale, light yellow, chrome yellow, 
orange, red, dark red, brown, and sometimes even approaching a 
brown black. The color is caused by the destruction of the red blood 
corpuscles, and is, consequently in such diseases as typhus, more 
prominent, inasmuch as they have a tendency to accilerate such des- 
truction. Pale and yellow urine, we find mostly eliminated from 
such patients, whose blood is not of a rich quality and in those who 
are getting over a sickness and in nervous troubles. In jaundice, 
urine assumes a color somewhat like dark beer with a yellow foam. 
This is caused by the elimination of bile through the kidneys. 

Sediments form often in the night vessels, and takes place either 
immediately after urinating, and sometimes after a while. Such 
urine should be at once taken from the sick room and the vessel 
thoroughly cleaned and disinfected. 

Even in slight indisposition the color of urine changes and is mark- 
ed by a strong yellow, orange red, or brown precipitation, usually the 
advance agents in fever. 

The urine sometimes contains mucus, pus and blood; these symp- 
toms are critical and show ulcerations in the internal structure of the 
track of the urine. 

One should urinate before we feel a pressure as the neglectful elimi- 
nation leads often to various complications, such as catarrh of the 
bladder and often to deathly inflammation of it. 

It happens, often, even after years, that the inflammation of 1 the 
urinating apparatus, leaves traces, recognizable by the difficulty ex- 
perienced in urinating, which is owing to the contraction of the tissues, 
and consequent partly closure of the apparatus. This, however, may 
also happen in old people and be caused from a general collapse. 



60 PERSPIRATION. 

It is very suspicious of stone in bladder, where one experiences the 
certain stoppage of flow of the urine, with pain in the regions above 
and below the sexual organs. If the latter symptoms are accompa- 
nied, in the morning upon arising from bed, by gagging and vomiting 
sensations, pains in the loin, swelling of the upper, and especially the 
lower eyelids, and also of the feet, it may be taken as a very strong 
indication of an approaching kidney disease. 

The excretions, by means of perspiration, are great aids in diagnosis, 
and a trained eye need not be told retrogression of perspiration is a 
bad sign and shows that the elimination of excrementitious matter 
by these means is stopped. 

The excrement of perspiration is caused by the excitement of 
the nerves. In a state of health heat causes the solution of sweat and 
cold ceases its flow. In the latter the skin is contracted through cold 
and in the former opened. Closing and opening of pores and an act 
within the human organism conformable to the laws of nature. 

A patient in state of perspiration in a heated room is. exposed to 
more danger in contracting cold than in a room of normal temperature, 
for the reason that the heated air will absorb the moisture on his 
body, far more readily, and through this absorption of moisture 
in the immediate vicinity of the body it becomes too suddenly cool- 
ed and has a congestive tendency. 

Too much care cannot be exercised with patients who are tempo- 
rarily mentally incapacitated, and who cannot reason for themselves. 
Their exposition, when in a state of perspiration, often proves to be the 
beginning of the end. 

Never suppress perspiration in cases after fevers, they are the ad- 
vance messengers for an early convalescence. To suppress perspira- 
tion of feet is one of the most dangerous experiments and leads to 
congestion of the venous blood vessels, consumption, etc. Better 
bear the disagreeable features and aleviate the illness by frequent 
washings. 

The odor caused by the evaporation of excrementitious matter should 
never be noticed in the sick chamber, and also not in the living and 
sleeping rooms of the healthy. Eesort to judicious ventilation, without 
causing a draught, and be convinced that pure fresh air is a balm and 
not a poison. People who are afraid of pure, fresh air are still in 
existence, to a very large extent. 

The symptoms of disease of the protective organs of the body — the 



COLOR OF THE SKIN. 61 

skin and its appendages — the visible mucous membranes, are of par- 
ticular interest, inasmuch as they give us something to see and to 
feel, obviates the necessity of going by signs, only indicative. Thus 
we can plainly perceive diseases of the skin, wounds, ulcerations and 
their contagion. 

Furthermore, the walls show us not only their own ailments, but 
also of the organs dependent on same. Diseases, such as pocks, 
Bcarlet, measles, jaundice, poverty of the blood, show themselves 
very decidedly on the outer surface of the body, but do not have their 
origin there. Catarrh of the stomach causes the skin to lose its 
fresh flush tint and assume an earthen color. Only a faint bronchial ca- 
tarrh causes a pale bluish aspect in face. Sluggish blood leave sits trace by 
a flatulent appearance and too much activity in the circulation, espe- 
cially when in the direction of the brain, protruding blood vessels and 
a reddish look. 

Dissipation shows itself to even the untrained eye in a sickly palor 
of face and impaired mental faculties. 

If we take it as gospel truth, that the eye is the mirror of the soul, 
we can truthfully assert that the skin is the same of the body. We 
read with our eyes the status of disease of our fellow being, if prop- 
erly instructed, and this A. B. C. etc., will make you comprehend the 
silent lecture, the father, mother, brother or sister, has often to attend. 

Instinct tells us to aid those who are suffering, the majority of 
mankind is willing to extend aid and this little volume is surely a means 
to admister the needed aid intelligently and effectually. Only master 
the intricacies of the body and you are not only an aid to yourself, but 
also to others. 

The color of the skin is established by the pigment it contains in its 
tissues and by the quantity and condition of the blood. The latter 
changes, however, freqently, according to the general condition of 
itself to the body and vice versa. So with these changes of the blood, 
the color of skin being dependent on same, its aspect also assumes a 
different hue. Changes in color of skin caused by exertions, either men- 
tally or bodily are a passing and only temporary event. If persisted 
in, they will lead to disease and show themselves in the color of the 
skin. 

Simple inflammation of skin we notice mostly in children and cor- 
pulent persons, and is either caused through friction, non-removal of 
sweat, urine and mucus in diarrhoea. It is tlso brought about in 
abnormal excretions, burning or frost. 



62 DISEASES OF THE SKIN. 

Eczema is an inflammation of the skin in consequence of congestion. 
It is mostly a disease of the face. 

Typhoid fever shows red spots on the skin of abdomen in second 
week. 

In syphilis, about two or three months after contagion, dirty red 
spots make their appearance on trunk and joints, and which become 
more decided when that part of the body comes in contact with cold. 
These eruptions have no itching or burning sensation as might be 
anticipated. 

Measles, accompanied by catarrh and an itching sensation of the 
eyelids, make their appearance first in the face in the shape of slightly 
raised, commingling spots, and from the face spread to all other parts 
of the body. 

Scarlet commences with fever, inflammation of throat, and prickles 
in the skin of a scarlet color, and not well defined, first on the neck 
and then the rest of the body, usually allowing the face to escape. 

Inflammation of Skin with perspiration in the tissues causes the 
formation of little knots, which are the origin of a itching and burn- 
ing sensation* If no vent is given to this sweat the horny part of the 
skin will form into blisters containing the excreted fluid. They are 
frequent at the corners of the mouth and signs of bad digestion. 

The skin excretes also a tallow through the sebaceous glands. Any 
interference with this excretion leads to the formation of little tallowy 
white knots with black heads on face and body. They are easily re- 
moved by pressure of a watch key on them (acne.) 

Barbersitoh is an inflammmation of the roots of hair, often very 
obstinate. 

Itch is a congregation of an animal parasitis, the itch-mite, in the 
skin; auguring channels in the tissue of same, which causes the 
agonizing itching. The disease is contagious. 

Corns and bunions are an enlargement of the horny part of the 
skin, always caused through some mechanical friction. Warts are 
swellings concerning the whole tissue of the skin, Liver spots, usually 
with hair are entirely harmless and are so-called mother marks. To 
remove them, the surgeon's knife is necessary, but in this operation 
the cure is worse than the " disease;" leaving a pit, similar to that of 
small pock. 

The skin is always more or less affected in all inflammations, as in 



GRANULATION OF WOUNDS. 68 

furnucle, consisting of an inflammation of the skin and fatty tissue 
supporating with a central core — a boil. Its origin is usually at the 
follicle of the hair. 

Carbuncles are a very painful acute local inflammation of the under- 
lying tissues of the skin and have a predilection for the hack of trunk 
or neck. They are characterized hy browny hardness of the affected 
parts, sloughing of the skin and deeper tissues and marked constitu- 
tional depression. It differs from a boil or furuncle in size, tendency 
to spread and the absence of a central core. Curbunclesare frequently 
fatal. 

Felon or Whitlow is an inflammation of the deeper tissues of the 
fmgere or thumb and occasionally of the toes. The pain commences, 
with pricking, throbbing and inflammation and is inclined to suppur- 
ation. Its process is slow and often affects the bones and sinews to 
such extent that loss of movement of joints occurs. 

Fistula often originate through minute ruptures of the skin and 
from inflammation of the muscles, sinews and bones. They consist 
of abnormal openings discharging pus. They are dangerous if they 
spread under the skin. 

Wounds in Skin depend on their causes, such as being stabbed or 
bruised. They are dangerous on this account, that where they occur, the 
body is robbed of the protecting skin. They are also to be carefully 
watched that no foreign substances enter the appertures, especially 
blood poisoning substances. The fangs of the snake, the tooth of the 
rabid dog or other animals, and the cut of a knife, previously in con- 
tact with spoiled meat or leather give us unquestionable proof of 
poisoned wounds. Immediate disinfection and proper bandage are 
proper safeguards in the first instance. It is better to have a wound 
bleed freely than to stop the same and allow it to accumulate in the 
wound; blood coming in contact with the air is easily disintegrate and 
carries decomposition to adjacent parts. 

Granulation of Wounds is always a good sign of healing, and not, 
as many imagine, that the little red spots of a wound are putrid and 
will cause spread of suppuration. It is only in contagion, that granu- 
lation cannot guard the body, as in hospitals where wound fever pre- 
vails; its germ may end in diphtheritis and blood poisoning. 

Lastly in the healing of wounds, we often, yes, nearly invariablv 
perceive pain, which is caused by the contraction of the tissues and 
enclosing upon the termination of the nerve fibres. Does this process 



64 MUSCLES. 

set in prior to the entire elimination of the pus and thus bars its 
egress, wounds are liable to break out on other parts of the body 
The blood and lymphatic vessels having carried the poisonous sub- 
stances to the regions where inflammation and subsequent suppuration 
occurs. Thus you see the cause of swellings on parts of body, where 
you had no reason to suspect disease. 

In diseases of the muscles we are mostly interested in their precision, 
power, elasticity of movement, and staying qualities; also theii 
quantity and solidity. They sometimes pain in movements and when 
subjected to pressure. Weakness, paralysis and cramps are usually of 
a nervous origin. It is necessary to find out which muscle causes 
pain and what its origin is. Loss of power is always accompanied by 
wastage of muscles and the indication is first shown by a certain soft- 
ness. In certain diseases the muscles vanish beginning at the ball of 
thumb, hand, arm, etc., as it may be notieed in case of lead poison. 

All muscles which have been bandaged, especially in plaster, and 
have, during this time, not participated in the general activity of the 
body, become weakened and somewhat wasted, which in the course of 
disease is an important sign of different diseases. 

Bruises can ruin a muscle totally. If a muscle is cut transversely, 
its fibers will draw back. On the trunk it may happen that the 
muscles become separated from the tendons. In all such cases the 
open or closed cavity thus formed will fill with blood and then healing 
sets in. Similar is the action on sinews, but the healing of same 
takes a longer time, inasmuch as they are not so well supplied with, 
blood. 

Local muscalar rheumatism and lumbago, if it is in the back or loin, 
consists of pain, of a stretching or tearing nature, and has its origin 
either in nervous excitation or fatigue and mainly through cold. 
Muscular inflammation with formation of pus is a very dangerous dis- 
ease and has a predisposition to lead to blood poisoning. The origin 
of this may be either from its connection with diseased bone, or from 
deep wound in the muscular structure. 

Bones. The diseases of this part of this part of the human anatomy 
are of a varied nature and especial attention is to be recommended in 
case of inflammation of the bone, owing to its origin, from the mar- 
row of the bone. Inflammation of the bone usually appears in chil- 
dren and is marked by a chilly sensation and strong fever, similar as 
in Typhoid. In such appearances investigation of the whole body is 






DISLOCATION OF JOINTS. 65 

necessary. In an acute inflammation a certain decomposition takes 
place, and such diseases are classed among the most difficult to cure. 
They need the best professional attention obtainable. The chronic 
inflammation of the bone, which usually appears in old age is also of 
a serious nature, and consists of a melting of the bone and disintegra- 
tion and leads to wastage of flesh. In the commencement of the latter 
disease it is often taken for rheumatism and is accompanied by a light 
fever, the skin becomes gradually reddened and shows a flabby swelling 
which when in state of suppuration produces a thin pus. The wound 
is surrounded by irregular warts and from tubular shaped openings 
flows for months and even for years a very liquid pus, till at last the 
poor sufferer is relieved by death. Often it happens that one of these 
open wounds heals for a time, but usually breaks out at other places. 
A real and effective cure of this malady is of rare occurrence and an 
exception to the rule. Often it happens that inflammation of the 
bones transfers itself to the joints. 

Bruises in bones and fractures, which, through wounds in the skin 
and surrounding tissue, become exposed to air, even for a short 
period are dangerous, owing to inflammation of the bone, induced 
through this exposure. Thus we learn of the invaluable service of the 
skin to the body. A plain fracture of the bone or bones is of no 
danger however, although often very painful, as long as the skin has 
not been hurt to the extent of rupture. The first described injury to 
bone is doubtless dangerous, while the latter under proper care and 
treatment is of no other consequence, as the temporary inconvenience. 
In order to avoid disfigurement of body and remorse in after life, any 
bones which have become fractured, especially those in the upper and 
lower extremities should be set and bandaged by an experienced 
surgeon. 

Contusions and sprained joints lead to swellings in the injured parts, 
and also prevents the active and passive movements of the same either 
through intense pain or through the tauntness of the swelling about 
the formed cavities of the joint. After a few days, in case of contusion 
or sprain the skin becomes discolored through the internal emission of 
blood. By ordinary care the blood will be absorbed by the vessels, 
but care must be taken after this, unless inflammatory troubles might 
form. Frequently the cartilages of the joints are injured by rup- 
ture, in which case the joint water or fluid leaves the cavities, as in 
the fracture of the kneecap. 

Dislocation of Joints is the separation or the ball of bone from its 



M THE NERVES. 

corresponding socket. The direction of the dislocation regulates the 
setting of course, by an experienced surgeon, and as soon as possible 
after the injury has been done. 

Inflammation of Joints is marked by swellings, heat, strong pain 
and loss of use. These symptoms lead to the formation of pus of a 
watery nature, which after suppuration comes to an open wound. 
Inflammation of the cartilages of the joints are often classed with 
rheumatism. These ailments must be properly attended to if you do 
not want misformation of the joint or, as often happens, the complete 
loss of its use. 

The diseases of the joints are mostly consequences of local injuries, 
which have not received proper care at their insipiency. Never wait 
in an accident, however so trifling, till fear sets in or the formation of 
inflammation and pus. Scrofula, Blood poison, Diphtheritis, Scarlet 
are the diseases which after a cure of them has apparently been affected, 
re-appear in the shape of joint troubles and the common acute rheum- 
atism of the joints in after life is doubtless attributed to them. 

The reader has learned and, it is hoped, has not forgotten the im- 
portant functions our nerves have to perform, and from it you have 
seen, that if the body, as a whole, is ill, the nerves partake of the 
ailment. 

Disease of the Nerves themselves is best seen by their excitability, 
which is ever-present, when any of our organs are dilatory in any way 
to the nerves. Thus are weak nerves or general nervousness attribut- 
able to the nonfulfillment of functions of the other organs. 

The nerves are irritated by our mental faculties, in thought and 
action, by our surroundings of solid, liquid and gaseous substances 
and coming in contact with our body. Also through mechanical and 
physical power; such as shock, pressure, friction, heat, light, cold, 
electricity and magnatism. Lastly also through the organs of our own 
bodies in their condition and functions. In our study we can easily 
change night into day but in doing so, will not succeed to the advant- 
age of a sound and healthful sleep. Through the effect of strong 
coffee or tea we can drive away sleep and thus compel our nerves to do 
without the necessary rest, the only tonic for overworked or weakened 
nerves. 

In cogitating about the many men and women, who suffer from 
nervousness, have you ever thought of the origin of this modern dis- 
ease? You can have a clue, if you only think of the constant influence 
the following articles will havs if y v i nsi the in to excess. 



INFLAMMATION OF THE NERVES. 67 

Tea, coffee, beer, wine, alcoholic liquors in general, tobacco in 
all its forms, besides these social and professional excitement, over- 
work and the numerous cases to motherhood have a tendency, to deny 
us the treat, which consists in normal and well rested nerves and 
their functions. 

The nervous constitution is of modern origin and attributable to 
the overindulgence of the previous mentioned substances and neglect 
to give our nerves a rest. From year to year we can notice the in- 
crease of nervous diseases and the undermining of bright intellects to 
be buried alive in the modern chamber of horror — the insane asylum. 

Excitement, if normal, is of as particular harm to our nerves, but 
to recapitulate and increase is dangerous. The nature of the excite- 
ment is also of no moment and we can paralyze their function by joy, 
scare, anger or the usiug of deleterious, still well tasteing sub- 
stances. 

Numerous cases of cerebral apoplexy are on record and caused by 
over joy, mental excitement and concussions. 

Overloading the stomach will irritate our nerves and stop digestion. 

Diseases of nerve tissue are similar to the other structures in dis- 
ease. To cause these a surplus of carbonic acid in the blood and a 
scarcity of oxygen will suffice, and thus it happens, when we have 
nervous disturbances that we gasp for air, — we want the oxygen. Nar- 
cotics like opium, and chloroform deaden the nerves and especially those 
which regulate the circulation. 

The nerves become inflamed in harmony with the other tissues and 
their sensory power carries the pain incident, throughout the whob 
body. Thus when we hurt our elbow projection, a place where the nerve 
fibers lie closely to the surface, we preceive the pain into the extremi- 
ties of the fingers. If you are troubled with corns or bunions and are 
of an experimental turn of mind, invite some corpulent person to step 
upon them, you will have pain all over the body. Sometimes we ex- 
claim that some of our extremeties "have fallen asleep," or been be- 
numbed ; in such cases we interfered with the circulation and robbed 
for the time being our nerves of their nutriment. 

Close observation and investigation furnishes us abundant informa- 
tion about the kind and location of nervous affliction. Nervous 
troubles are very painful and it is not in isolated cases by any means 
that the sufferer of cramps and neuralgia has resorted to suicide, to 
relieve forever his physical ailma -.its. Offcen the very smallest inter- 



68 RESPIRATORY NERVES. 

ference with the nervous functions and tissues are causes of intricate dis- 
eases. A minimum hemorrhage can rob the patient of his voice, or the 
functions of the heart may cease. Hysteria and cramps benumb the 
sufferer and his or her friends witnessing same are scared unto death. 
Whether these symptoms are dangerous to life, or whether they are 
the cause of untold pains, or pain and anxiety of those surrounding 
the sufferer, the best consolation and assistance to the patient is a 
careful investigation of the disease which enables you to act accordingly. 
To do this intelligently, so that your efforts will be crowned with suc- 
cess is the object of this work. 

The untold agonies a patient suffers from badly informed nurses, 
have often been the cause of dissolution and we must insist that before 
the patient is shaken, or cold water is thrown upon him, or talk to 
him in a loud voice, or in order to awaken him from his lethargy, that 
you inform yourself of the cause. The usual demonstrations just 
mentioned and so often resorted to are in many cases harmful. 

For the continuance of life it is necessary that the functions of 
respiration and circulation are in activity. Have they ceased, or are 
insufficient through some cause? These are questions, which, in cer- 
tain dangerous catastrophes, are answered by the patient, by his 
imploring look, or gasping for air, or moving his hands to the regions 
of the heart. If the sufferer is incapacitated or even beyond the per- 
formance of these signs, place your ear close to his mouth or nose 
and observe whether his respiratory functions are in operation yet, 
or place your ear over the regions of the heart,or hands, on one of the 
arteries at wrist or along neck and feel whether you can preceive the 
pulse. 

In nervous troubles we must watch these symptoms with great care ; 
acute diseases we must also watch with regularity of respiration and 
pulse, than if abnormal in this respect we can conclude that changes 
take place within the organism, which are no signs for the better. 

Of great importance in nervous prostration is whether consciousness 
exists or not. Never resort to loud calls or any kind of noises ;they are 
useless, and only cause shocks to the patient if his consciousness is not en- 
tirely gone. The tickling of the mucous membrane in the nasal cavities, 
slight rubbing of the tongue and palate by means of a teaspoon handle irri- 
tates sufficiently to make the respiratory nerves do their duty and you 
will soon be rewarded for your endeavors by observing his breath. 
The nurse must not become anxious when a patient does not resort to 
speech for some time, and in fact should not be urged. 



BED SORES. 69 

We canuot assume that death has made its appearance, even when 
we do not perceive respiration, circulation, consciousness or locomo- 
tion. In such condition the sufferer is in a trance. Do not resort to 
such nonsense as holding a mirror over a patient's face or pinch 
him, but endeavor to restore respiration by gentle rubbing of the 
chest and having as few persons in the room as possible, and be care- 
ful to keep up, by artificial means, the temperature of the body. 
Slight and gentle rubbing of the wrists and turning the patient from 
side to side will aid in the restoration of some of these paralyzed functions 
and by these careful and tender cares, death has been robbed many a 
time, of a victim. Electricity, if applied by an experienced practition- 
er, is a great aid in restoration of nervous collapses, but the layman 
should never resort to same for fear that a too strong current might 
be the cause of dissolution. 

In nervous diseases of long standing, where death is slow to ap- 
proach, sickness destroys gradually, the power of the body and the 
patient suffers in consequence of the lack of nerve functions, to such 
extent, that he cannot even tell his sufferings. We must watch and 
assist, and at least endervor to alleviate his sufferings. So when we 
see his mouth open, his tongue parched, his lips nearly cracked and 
sometimes even emitting the life's nutrient fluid — blood; — the patient 
suffers with thirst, and often has not the power to guide a refreshing 
draught to his lips, or to swallow the fluid when in his mouth. Assist 
and induce him by kind word and actions to endeavor to swallow and 
if successful, you can read thanks in his eyes which will be graven 
deep on your own memory. Usually when a sick person can not be 
aroused to respond to acts of kindness and service of love, he lies in 
hsi bed and apparently not caring the least for his surroundings, 
emitting a grumbling noise which are words beyond comprehension, 
pulls at his blankets, his respiration is hardly perceptible, but occasion- 
ally interrupted by sighs and gapping, his heart's action becomes 
feebler. It depends now on the amount of power he has left, but it 
cannot last forever, disease consumes it faster than his ill body can 
restore same. Breathing becomes slower, the intervals longer, like- 
wise with his pulse. The end is approaching, suffering ceases, and 
the spirit of our friend has crossed the chasm. The nervous system, 
the intricate machinery in our body has collapsed, and the matter 
remaining will return to its origin — Earth. 

The wounds or bed sores are caused by an abnormal inactivity of the 
skin nerves, and can happen even to such sick persons, who are cap- 



70 THE BRAIN. 

able yet of moving to some extent in bed. The nurse can show his or 
her worth to great advantage in preventing this disagreeable and 
weakening disease, by cleaning the part of the body which comes in 
contact with the bed clothes, by gentle friction of the parts supposed 
to be on the down course, by rubbing the back and sides of the trunk 
and extremities with bay-rum or diluted alcohol. The life of the sick 
is in much danger, when aggravated by bedsores and his convalescence 
is more distant. 

The stool and urinating ought to be specially watched in nerve 
affliction. In the last stages of diseases of this nature and many 
others, the emission of excrement becomes involuntary and 
shows the weakness of the nerves regulating these functions. It may 
also happen that these excrementory passages stop entirely, also for 
want of nerve power. In diseases of a serious nature, the latter will 
increase fever alarmingly. 

A prominent part in nerve affection is played by the mental faculties, 
which are closely allied to the other nerve functions. 

The formation of the brain is of an exceedingly delicate nature, so 
much that nature has provided for its protection, a strong box — 
the skull. Very fine tissues give the nerve fibres and cells a fixed 
foundation. Like all other tissues of the body, but the brain specially, 
these meshes, are interlaced with numerous bloodvessels, bringing, for 
the proper performance of its duty, nutrient matter, in the shape of 
arterial blood, through the arteries. From the capillaries the brain 
tissues receive it and also transfer to same the waste matter to be 
returned as venous blood to the heart. We notice through the heart's 
action the flow of blood to the brain, and from it, thus insuring the 
requisite temperature ; circulation and respiration enlarges and de- 
creases the contents of the cranium, best noticed by a gentle touch on 
the head of young children. The brain is also inclosed in a membrane 
same as the lungs, securing it against friction and thus enclosed in the 
skull, which is further protected by skin and hair. This most wonder- 
ful part of our anatomy, performs functions, truly phenomenal in their 
nature. 

Concussions, pressure and friction are liable to break the skull and 
injure its contents and causing internal hemorrhages. Often, however, 
strong mechanical shocks, without breaking the bone lead to similar 
results and concussions of the brain. The impression of bone splinters 
from the skull, or hemorrhages, lead to inflammation of the brain. 



DISEASES OF THE BRAIN. 71 

Internally, many injuries can happen to the brain. Inflammation 
of the membranes causes disease of nerve cells and fibres. The fre- 
quent rush of blood causes congestion usually after hearty meals, or 
the over indulgence in tea, coffee or spiritous drink. The stoppage of 
the flow of blood in the brain causes the same trouble. 

It is under such circumstances that old people die suddenly, their 
arteries and veins being weak through long use, become ruptured and 
overflow the brain — Apoplexy. 

Poverty of blood and not a sufficient flow to the cranial regions, can 
be caused from external bleeding, or also from the general low quantity 
in body. 

In sunstroke we see a picture of overheating the brain from external 
causes, and it is similar in fever, having its origin from the interior. 

To cool the head externally use ice on top, to cool internally, 
make cold application along the neck, thus the blood flowing to the 
brain becomes tempered. 

Chemical influences can only be brought to bear upon the brain, 
through the blood. To these belong tea, coffee, spirituous drink, 
numerous medicines are also made effective through the same channel 
such as opium, and choloroform. 

Many poisons find their way to it by this route. Sewer gas, car- 
bonic acid, lead, evaporations of arsenic, etc. 

Tendency to sickness exercises its influence upon the brain. Pain, 
if strong, often benumbs our mental faculties. 

The brain in itself is void of feeling, and only through irritations of 
the membranes are the origins of the numerous headaches. Light 
swoons and total loss of conscience are proofs of strong interference 
within the brain or of its functions. 

Insanity is a disease of the brain, caused through excitement, as in 
delerium, mania and frenzy, or through organic weakness and paralysis, 
which manifest thhmselves in hypochondria, melancholia or idiocy. The 
insane are driven through wrong thoughts and conceptions to nonsensi- 
cal acts and crime. Hypochondriacs imagine all sorts of things. 
Those suffering from melancholia believe that they have lost all friends, 
and lose even faith in God and human justice or believe that their 
footsteps are followed, lastly they feel insulted at almost anything, 
even kindness and often attempt suicide and murder of others. 
Idiocy is incurable, the afflicted are harmless and only through ignor- 
ance commit crime. 



72 THE EYE. 

Of the majority of mental diseases few have a tendency to shorten 
life. 

The eye is the seat of many disagreable diseases, but its main inter- 
ference is in its power to see. Near sightedness and far sightedness, 
or myopia and hypermetrovia. These conditions of the eye lie in the 
faulty construction of the lens. 

In myopia, or nearsightedness, the eye is otherwise, normal only its 
anterio-posterior diameter is longer than usual, thus placing the restina 
at a greater distance behind the lens. Consequently the rays are brought 
to a focus at the usual distance behind the lens ; this focus is situated 
in the vitreous humor, and the rays reach the retina only 
after their crossing and partial dispersion. This produces indistinct 
vision for remote objects. But for those at shorter distance the rays 
enter the pupil under such a divergence that their focus falls at the 
retina, and the object is distinctly seen. The evil is corrected by the 
use of a concave glass. Hypermetropia or farsightedness is a condition 
of the eye in which, through shortness of eyeball or fault of the lens, 
the rays of light come to a focus behind the retina. This inconveni- 
ence is corrected by the use of convex glasses. 

The inability to distinguish various colors constitutes color blindness; 
weak eyes and nickering are diseases of the optic nerves. The involuntary 
flow of tears, blood shot, squinting, inequality of pupils or dispropor- 
tionate opening of same, are attributable to the same cause, namely, that 
of the moving and optic nerves. The most important and at the same 
time excessive dangerous diseases of the eye are to be found in the 
retina. This should be left to a specialist in eye diseases. 

We are very often troubled with our visionary organs, the usual care 
and all sorts of eyeglasses give us no relief. There are usually forma- 
tions of membranes on the internal coats of the eyes, the lens becomes 
opaque or non-transparent, the vitreous and aqueous humors become 
clouded, the retina inflamed, the cornea loses its transparency, the 
lids are paralyzed and the tear apparatus refuses to bring forth lubri- 
cant. Thus our vision becomes infracted and we suffer pain. The 
least suspicion of troubles of this kind should hurry you to an experi- 
anced oculist, who has made a life study of the eye ; even when it 
costs you every cent you possess or can borrow. Remember sight is 
priceless. 

External diseases of the eye, such as sty, inflammation of the lids 



THE EAR. 73 

or their mucous membrane are more easy to treat and do not require 
such profound learning as one might imagine. 

The consequences of diphtheritis, scarlet, and sundry diseases also 
bear close watching as to whether these diseases do not intend to rob 
their victims of sight, out of revenge, for not having obtained the 
whole body. 

The ear shows symptoms of disease on its external and middle 
part, and we can observe it even to the tympanum at the 
extremity of the auditory canal. Here we find often obstructisns in 
the shape of an accumulation of ear wax, which quite often obstruct 
the auditory channel. Our attention is drawn to it by queer noises 
more than by pain. Even in the perception of our own voice, the 
vibrations seem strange. 

Small children often put peas or beans into their ears and thereby 
obstruct the passage. Sometimes insects, which defy the poisonous 
nature of the ear wax enter the ear, leave the sting of their 
fangs, causing inflammatien and influencing our hearing capabilities 
and furnish germ for the transmission of diseases to the middle and 
internal ear. 

The diseases of the middle ear comprise the tympanum and its 
cavity, the eustachian tube and chain of bones. Disease in this part 
of the ear is usually caused by transplanting the catarrh of ear and 
mouth. It is thus accounted for that we are hard of hearing when we 
are afflicted with catarrh. If the middle ear is affected, it causes 
heavy pain. Inflammation may be also transmitted to the tympanum 
and be ruptured in consequence and its cavity is then exposed to all 
sorts of weather. The mucous membrane suppurates, ear polyp are 
formed and pus leaves the ear, emitting an order of a peculiar and 
sickening smell, which to some sensitive people is unbearable. Do 
not console yourself that it is caused by the breaking out of scrofula, 
which should leave the body and thus beeome cleansed. Parents will, 
in after life regret their neglect, when their offspring cannot enjoy the 
guiding words of father and of mother. Inflammation of the in- 
ternal ear, as well as its middle portion, is easily transmitted to the 
surrounding bone and to the brain. In the latter case death comes 
like the thief at night, unannounced. Chills, fever, loss of conscious- 
ness and death is about the course when inflammation is transmit- 
ted to the seat of our senses. 

In diseases of the internal ear deafness will soon make its appearance 



74 CATALEPSY. 

This happens to children; they not only lose their sense of 
hearing, but also the use of speech, become deaf mutes. 

Partial or total obliteration of the senses of smell and taste, are 
caused by nervous troubles, catarrh, and interference in the digestive 
functions. 

The movements of the body shows deeds, and these are the fruit of 
thoughts and especially the manner of forming them. 

The Carriage and locomotion of the body, countenance in repose or 
activity, and speech furnish us many proofs of disorganization of the 
nervous system. A frequent sign of nervous disease is shaking, and 
if especially noticeable in tip of tongue and fingers, it is a sign of 
alcoholic poisioning. 

Cramps are spismotic contractions of singla or groupes of muscles 
and is a morbid condition in which excitement of the motor nerves 
is produced by an irritant of unusual, and, generally speaking, of un- 
known origin, and entirely independently of the volitation, or else to 
a condition in which the action of an ordinary stimulus calls forth an 
excitement of extraordinary extent and violence in the motor tract. 

In cramps, which appear and pass off again, can be enumerated 
epilepsies which under that head will be respectfully described. 

Catalepsy shows its symptoms by headache, dizziness, buzzing in the 
ears, broken sleep, extreme irritability and other symptoms of nervous 
derangement. The patient remains motionless as a statue in the atti- 
tude in which he may happen to be at the moment of the attack. 
During the fit, consciousness and sensibility to external impressions 
are either entirely suspended, or else, though the senses may be re- 
tained, and though external impressions perceived, the patient is 
unable either by word or act to give any sign of consciousness. The 
respiratory movements and beat of the heart and pulse are usually so 
feeble as scarcely to be preceptible, Generally speaking such fits only 
lasts a few minutes, and very seldom for several hours or more rarely 
for days. When the patient has passed through the fit he yearns and 
sighs like a person just awakened from a profuse sleep. Between the 
fits the patient enjoys good health unless there is complications. 
Kecovery is the most frequent termination of single catalepsy. The 
dread lest cataleptic patients should be buried alive has become ex- 
ploded in modern days. 

It is very seldom that cramps cause death, and they have not the 
tendency to shorten life, even if they occur at frequent intervals. It 



RULES IN NURSING. 75 

is the cause of cramps, which leads to death. Such as poisoning, 
bleeding, asphyxiation, and mostly temporary emptiness of the blood 
Tessels in that part of the brain, presiding over the affected location. 
The tendency to cramps can be located in all parts of the body. It is 
a well known fact, that tape worms have been the cause, wounds of 
different kinds and foreign substances in the cavity of the ear. 

You have now learned in this mental trip through the human body 
how symptoms of disease appear in the different organs composing 
same and also how they originate. We have considered the organs 
of nutrition so necessary for the preservation of our health and capa- 
bilities, as well as the organs in which the unknown resides and pre- 
sides over our matter. By the careful study of these lines, you will 
acquire a knowledge, which will serve you in the noblest of all works, 
the alleviation of sufferings of those dear and near to us and mankind 
in general. 

To study the mind, the body and the two combined will leave you, 
when abnormal changes and derangement in their functions exist and 
that constitutes disease. 

GENERAL RULES IN NURSING AND HEALING. 

We have learned how the body tries to protect itself from the 
changeable influences of its surrounding and how we can expect pro- 
tection to the body, by the exercise of the mental capabilities. 

Of all created beings, man is the least provided with natural 
weapons in the battle of existence. He has no feathers or densely 
hair covered skin to defy inclement weather; nor can he create with 
his teeth, or other natural weapons, a respect or fear in his co-creatures. 
He has invisible weapons, his soul, his mental faculties, and these 
give him power over all. 

Man cannot always reach his aim, by the exercise of his own in- 
dividuality, he must utilize the thoughts of others and thus reach in 
unison with others his object. And under this rule man will learn, 
while in health, to prepare himself for his own good and those of 
others, how to act in sickness. Talent is often born in the human 
being, but oftener acquired — and especially the talent of nursing 
partakes the least of a hereditary nature. It has to be gathered, not 
only through practice, but mainly through the acquisition of the 
knowledge of the body in state of health and disease. The latter pre- 
pares and the former puts on the finishing touches in an accomplished 
nurse. Therefore read and prepare yourself for the time when you 



76 THE SICK. 

have to practice, for nature in its course will not wait, till you acquire 
the knowledge so needful to help the sick. 

Women in their calling are nurses. Their bodies are the perpetu- 
ation of life, by bringing into world their offspring, which in the first 
nine months is a part of and in them. From them young life rec- 
eives its nutriment. The highest aim of the mother should therefore 
be to keep herself in health and to learn how to regain it, when lost. 
Her health is the health of her children, in whom her life is 
perpetuated. To accomplish all this, woman needs strength, in order 
to develop others and to care for those, who look upon her as the 
fountain head of life. 

According to her best understanding the mother will protect her chil- 
dren and stimulate through her virtues, the father to provide means, 
and when sickness comes, or even worse, the last summons, the hus- 
band looks to his wife, children and to the mother for succor. She 
suffers with her dear ones ai.d gives such relief as is at her command. 

Such being the case, it is evident, that women are better nurses, 
their sympathetic natures obligate them to assist in sickness, even in 
cases where no kinship exists. 

Even a child unable to complain, or a husband not desiring, the 
mother and wife cannot be deceived, when those surrounding her are 
sick. Even the faintest signs, such as loss of appetite, gapping, 
sighs, disturbed sleep do not escape her attention, and she Deed not 
be told that her dear ones are sick by the more aggravated symptoms, 
such as chills, fevers, etc. 

Mothers will save themselves many hours of anxiety and multitudes 
of care, if they acquire a knowledge of the symptoms of disease and 
how to combate them. Often her baby, afflicted with only a tempor- 
ary indisposition, for want of a knowledge and comprehension, will 
cause untold agonies in the mother and her mental sufferings are far 
greater than the physical ones of her little darling. 

Every nurse should be able to observe the present condition of the 
organs, of mental activity, of sense, thought and action, the height of 
fever and the examination of the organs of nutrition, respiration and 
locomotion. This knowledge will lead her then to action, with a 
view to ameltorate the sufferings of the sick arid effect a cure; or in 
aggravated cases to call in professional aid. 

The mode of life of the sick must, pre-eminently, be a simple one, 



THE DIET. 77 

in order that the body can collect material for the replacement of the 
wastage of disease. 

The arrival of disease always causes an inconvenience and comes at 
a time when we have other things to do for our bodies. We must 
deny the anticipated enjoyments which we have dated, when this un- 
welcome guest enters our body, we must refrain from work in most 
cases, simply for the reason that all the nutrient parts of our blood are 
required to restore health — and that takes precedence over pleasure 
and work. If we violate these rules or allow our children to do so, 
nature will take its revenge. Carelessness in providing proper care 
and medicine, and the hope that disease will pass away without these, 
has mortified many a father and mother and the tears they shed over 
the grave of their child were of remorse mingled with those of grief. 

It is in the beginning of sickness, that the body should be with- 
drawn from further deleterious influences, and our attention be 
directed to the removal of the cause of the disease. 

Hence, one of the first principles in nursing, is not to ask of the 
body work, of a mental or physical nature, but to furnish to it, all 
needful things, which will strengthen or rebuild, weakened or lost 
parts. In disease, the tissues waste quicker than the ordinary func- 
tions can replace same. 

The nurse must judge, aided by the theoretical and practical experi- 
ence, and from observation, as to the health, and the capabilities of 
the body, also what results are obtained, good or bad, from the food 
he eats; the air he breathes and the occupation, either mentally or 
physically. 

A sound body can undergo a great many diversifications, without 
injury to health or capabilities, but this is not the case with the sick. 
You may eat a hearty meal and through the activity of the body 
digest it in proper form, but when the body is sick and cannot take 
part in physical or mental work, you must not be tempted to force 
nature and abstain from placing food in his digestive apparatus, 
which it is unable to digest. Hence it is the duty of the nurse to step 
in and regulate, for sick people, who are, owing to their ailment, in- 
capable to discriminate. 

Nursing and treatment go hand in hand, and, in fact, are two 
inseparables, for without either the results are poor. 

The Diet. The diet of the healthy must conform to the age, sex, the 
climate we lives in, and the occupation. The only occupation of the 



78 NOURISHMENT. 

sick is that to get well, the climate is regulated according to circum- 
stances by means of bed and sick chamber. The bill of fare, however, 
cannot be written in one recipe, and changes with nearly every 
sickness. 

It is natural that the sick need the same nutriment as the healthy, 
but if the body does no work, as is usually the case with the sick, the 
quantity need not be so large and this is specially the case in the 
matter of fat. In nearly all diseases, the digestive apparatus has 
difficulty with fats of all kinds, such as steaks, chops, etc., fried in 
lard or butter, soup with fat on sauce, or plain every day butter. 
Many of the diseases cause an aversion against anything fat and in 
the patient numerous sensations whioh are manifested in hickups, 
heartburn and an oppressed feeling in the region of the stomach. 
Fat, however, is one of the principals, through which our body receives 
warmth, and nature has provided us with a substitute — sugar, or 
those nutrient articles which change through the process of digestion 
into sugar. The ratio as to quantity does, however, differ; then for 
10 units of fat, the body needs 17 units of articles producing sugar. 
From it, it will be seen, that the work of the digestive apparatus, by 
this substitution is considerably increased and, therefore, we can not 
rely upon the substitute whether it will furnish the requisite nutriment 
for the purpose. One of the main substances which the body needs in 
disease is albumen, it is the material needed to rebuild the lost tissues 
and which prevent the collapse of our soul's abode and for this pur- 
pose, best adapted, is egg food, properly prepared, and the soups, made 
of bone and veal knuckles, properly freed of all fats. 

In fevers fat and sugar or sugar creating substances must be 
entirely avoided as they will increase the heat of the body, thereby 
heightening the fever. In the latter the body assumes great quantities 
of moisture, in proof of which observe the nearly unquenchable thirst. 

Appetite exciting condiments such as pepper, mustard, horseradish, 
catsup, all the hot sauces, while stimulating the stomach and intestine 
and bringing them to activity, have a too strong tendency to excite 
unnecessarily the nerves with which they come in contact. And as 
the nervous system, especially in fevers, is subjected already to more 
excitement than good for the health, these ingredients in their reaction 
will cause a collapse of the nerves for the time being. Hence those 
articles do much harm and must therefore be entirely eliminated from 
the dietary list. These condiments are only useful in health in the 



REGULATION OF DIET. 79 

stimulation of the digestive apparatus and then only when used 
moderately. 

To create an appetite, either when in health or sick, by taking 
alcoholic liquors of any kind, cannot be too strongly condemned, as 
its effect upon the mucous membrane of the stomach is a paralyzing 
one to the peptic glands, and shuts off the flow of gastric juice. A 
false appetite is, however, created by the irritated condition of the 
stomach and it cannot commence its function of chymification, till it 
has recovered from the alcoholic effect. Hence we carry a dead load 
in our stomach and thereby weaken it to the detriment of the whole 
system. 

Through the diet in sickness, we can also, to some extent, regulate 
the stool, a matter of the greatest importance. The effects of the dif- 
ferent dishes vary so much with the different constitutions that it 
would be impossible to treat the subject satisfactorily. In some milk 
facilitates in others it obstructs the stool, while in some, it has a 
tendency to form phlegm, and some claim for it all sorts of beneficient 
virtues It is further to be recommended, not to listen to all the 
dietary remedies your good neighbor may suggest; they may have 
done good in their cases, but with your afflicted may have a direct 
opposite effect. 

In general the composition of the diet for the sick should be rich in 
albumen, to rebuild the tissues, and especially water should form the 
bulk, in order to facilitate assimilation and avoid work for the organs 
of digestion. They should contain very little sugar creating sub- 
stances, no fat and little salt. "When you meet with evident loss of 
strength, resort to beef tea and pure wine, being specially careful with 
the latter. 

Inasmuch as in all diseases the digestive apparatus is more or less 
weakened, the food must be prepared so that it can be easily assimilated. 

Consequently nourishment is best served in the form of soups, 
graduating its consistency with the stage of convalescence, till in its 
latter period you can resort again to solid food. 

Large quantities of food require a corresponding tissue for its diges- 
tion, which requires power. The sick, not having a surplus of it to 
spare, in its weakened condition, must take small meals, at shorter 
intervals, and thereby give an opportunity to regain the power 
expended . 

The cleaning of the mouth and teeth, as well as slow and perfect 



80 PLAIN FOOD. 

mastication, must be insisted upon in all stages of sickness. 

In cases of fever give only plain liquid food to the patient, warm 
and solid nutriment is distasteful to him, and has a tendency to elevate 
the temperature. 

You cannot always complv with the wishes and desires of the sick 
in dietary matters. The nurse has to regulate that for him, then, 
when sick in body, he is usually mentally incapacitated to select for 
himself the food best adopted in his case. Give you rsick such a variety 
of food as may be consistent, monotony of diet will spoil his appetite 
and he will refuse food entirely. In high fevers meals must be fre- 
quent but small. 

Always respect the sleep of the sick, no difference whether day or 
night, and do not interrupt it with meals. A little refreshment of 
some nutrient substance is always welcomed by the sick when they 
awake at night, give it to them, when asked for, or if long without 
food, urge it upon them gently. Fever is always highest between 
five and six, p. m., and as food increases warmth of body, never give 
it before that hour, as it would aggravate the fever. Warm food must 
at this time be especially avoided. During the night the temperature 
of the body usually falls and does not increace preceptably during the 
morning hours, hence the propriety of giving food during this period. 

Care must be taken, especially in fevers, that the patient has at 
least once a day, a passage. Accumulation of excrement in the bowels 
increases fever rapidly. If possible regulate the stool by means of 
diet, such as stewed, fresh and dried fruit. 

The best nourishment in fever is milk, buttermilk, well beaten 
white of egg, seasoned with a little sugar and salt. Such diet is, of 
course, only fit when the patient has ample strength. For grown 
people the above may be taken in connection with some dry toast. 

Gruel or porridges of flower, meal, farina barley and the other 
numerous creals are better prepared with milk and an egg stirred in 
than with water. Oatmeal, barley, rice, should boil at least two 
hours under constant stirring, or prepared in a steam pot. They 
should always be strained through a fine sieve or gauze cloth. 

Very tastey and refreshing are the fruit soups for the sick ; their 
value consists in the refreshing qualities and not in the nourishment 
they contain. Equal to these are the home-made jellies. Almond 
milk is a great tonic in cases of fever, but must be partaken of, in small 
quantities only. 



DIET. 81 

In loss of strength resort to beef tea mixed with fresh milk and egg. 
The meat extract, now to be found in nearly every grocery, aids 
greatly in digestion. It is more of a tonic than a nutriment. Tea 
and coffee can be used in most diseases, but cocoa and chocolate must 
be entirely eliminated from the dietary list. 

In some diseases, where loss of strength is so rapid that it cannot 
be rebuilded by the ordinary means of food, we must resort to wine, 
but it should be done under the direct supervision of the family physi- 
cian or a trained nurse. In such cases, purchase only the very 
best and the brands known as Tokay, Malaga, Madeira, Port, Sherry 
and chamgagne are best fitted. In this connection it may not be out 
of place, to warn against the purchasing of these wines at a saloon ; the 
majority of wines dispensed at these hell holes are only immitations, 
and consequently are deleterious. There are exceptions, however, 
to this rule, and one may find in these places wines fit for medicinal pur- 
poses, but it is an exception. The drugstore which is known to sell 
pure articles is the place to be resorted to as a rule. Wine, whenever 
prescribed or taken in cases of sickness, should always be administered 
in very small doses and under no circumstances more than a table- 
spoonful at one time. This, of course, refers to adults. Children's 
diseases usually can be treated without this medicine. 

The diet for convalescence is, in its first stage, also best in the 
form of soups, and as it progresses, the more solid forms of food may 
be used again. 

In order that the mother or nurse may not be bothered with thoughts 
as to what to give and prepare for their afflicted, a brief list of nourishing 
dishes and the mode of preparation is added here, and from it a suffi- 
cient change can be selected. 

OATMEAL PREPARATIONS. 

Boil meal free from all dust and flour in water for two hours, either 
in a steampot or under constant stirring, keeping in it sufficient water 
that it remains a fluid mass. When perfectly done strain through a 
fine sieve, add a pinch of salt, and let the sick drink of same, either 
warm or cooled, but never ice cold. If they like the taste add some 
granulated sugar and lemon juice, which makes it to come a very 
palatable drink. Instead of using water to thin the gruel you can 
also use fresh milk and this is especially to be recommended in cases 
of fever. 



82 PREPARATIONS OF FOOD. 

Barley, hulled wheat, hominy, and grits generally can be prepared 
like oatmeal. 

LIQUID BREAD. 

Take two or three slices of toasted wheat bread of a nice even 
yellow color, without scorching same, lay it into a deep earthenware 
dish, allow gradually to cool, flavor with a little lemon juice and 
sugar; strain. 

Or boil one pound of stale white bread in three pints of water one 
hour, strain through linen cloth and season as above. 

APPLE DRINK. 

Peal and carefully core 5 or 6 perfectly ripe apples of a quality best 
suited for cooking purposes and put them to boil with one quart clear 
water, using earthen or enameled iron vessel, cover well and allow to 
simmer one hour, strain all juice through linen cloth, allow to settle, 
and add four ounces grated bread, or toasted bread crums, eat either 
cold or warm, in latter case heat the juice before adding the bread. 

FRUIT WATER. 

For a pound of fruit of any kind, freed of seed, take one quart pure 
water, let it eome to a boil, strain and add eight ounces granulated 
sugar, filter carefully and keep in a cool place. If you make this 
preparation of strawberries, add the juice of one lemon. 

STRENGTHNING DRINK. 

Take parched barley or malt and boil in water, adding two or three 
bread crusts, sugar to taste, and flavor with jelly or fruit jam; strain 
carefully. 

Another. Take the yellow of one egg, beat it for fifteen minutes 
with powder sugar and add to it one-half pint of either boiling tea or 
milk, doing this s.^wly under constant stirring. This is a good drink 
in cough and cold, also for those suffering with consumption. 

ALMOND MILK. 
Peel one-half pound sweet almonds, grate them, or macerate them 
in a mortar, add to it one quart pure cold water, stir for 10 or 15 
minutes and strain through a fine linen or cotton cloth. It does not 
keep over 24 hours and is best when fresh. 

LEMONADE. 
For a water glass full, peel one lemon and extract the juice, mix in 



SOUPS. 88 

with a heaping tablespoonful of powder sugar till sugar is dissolved 
and fill glass with cold water, strain, and drink through straw or glass 
tube. 

FRUIT LEMONADE. 

Take strawberries raspberries, currants, cherries, or any other fruit 
and extract all the juices from it, add sugar, a Jittle chipped ice and 
water, mix well, and use as lemonade. Always make fresh if you 
make for more than one or two drinks, boil the fruit juice to kill the 
fermenting germs. 

SOUPS. 

Take the lean meat of either beef, mutton, veal, old chicken, or 
pigeons, or if you can get them, young rabbits; chop the meat medium 
fine and put to boil with cold water, skim carefully, add boiling water 
as may be deemed necessary, add a pinch of salt, a piece of carrot, a 
small onion, a sprig of parsely, but no spices; boil till meat is nearly 
dissolved and strain. Put such quantity of this broth as your patient 
may need in a separate stew pan and bring to a gentle boil, and add 
to it one egg, well beaten, and see to it that the egg does not cur- 
dle. A tablespoonful of fresh cream also helps the soup and the 
patient. The above is very nourishing. 

When making this broth for a convalescent, add to the meat a veal 
kunckle or a beef soup bone, otherwise proceed as above, but be care- 
ful that the soup does not contain any fat whatever. If the digestion 
of the sick is fairly, the soup may be thickened with well boiled rice, 
barley (must be strained,) farina, home made noodles, sago or tapioca. 
It is well for rice or barley to be soaked for 8 to 10 hours and then 
boil them to a jelly. 

Soup is surely the easiest article to digest and as all invigorating 
and strengthening principles can be incorporated in same, it should, 
above all things, be the form of nutriment given to the sick and also 
in the first stages of convalescense. 

In convalescence and in all diseases which are incurable, where 
it becomes necessary to build up or maintain strength, the semi-solid 
foods are in place. 

Slowly made toast, without burning or scorching the bread and 
served with boiled cream or milk, or stewed in strong beef tea, or 
with the addition of a soft pounded egg, is good food. Do not use 
butter, at least not in large quantities in the different toast prepara- 



84 SERVING THE MEALS, 

rations. Always use yeast bread, which has been baked at least 
twenty-four hours. 

Raw beef, scraped with a dull knife, so that all strings and sinews 
are removed, adding to this mush of beef one yolk of egg, salt to suit 
and a few drops of lemon juice. This well mixed spread on toast is 
not only palatable, but also strengthening. Some people, before be- 
coming acquainted with this dish, have an aversion against raw meat 
of any kind and may be induced to eat it between two thin slices of 
toast. They will soon learn to take it and the aversion will vanish, 
when they see the good it does them. If you do not succeed with this 
device, do not try to force them to eat it, as it might produce vomiting, 
which is weakening to the system in these stages. 

Stewed frog legs with white sauce made of cream and corn starch is 
a good dish for people on the road to recovery. 

Tender beef steak (tenderloin, if you can procure same), lean mutton 
chops, veal chops, young chicken or turkey, nicely broiled (but never 
fried in grease) are the proper things, when in a state of convalescence. 
Season these meals with salt only, and use as little butter as possible. 
Always serve these meals on toast. Of the fish kind, all those which 
have scales may be used when broiled, or boiled in salt water but 
never when fried or baked in grease. 

Raw and soft poached or boiled eggs are good food for sick and well 
people. 

Of bread only yeast raised wheat bread made without shortening, 
should be used in the diet of the sick and mostly in the form of toast. 

Vegetables of all kinds are injurious to sick people, and only tender 
spring vegetables fresh from the garden are admissible in the latter 
stages of convalescence. Potatoes must not be used at all in scrofu- 
lous diseases. These blessed roots aggravate that illness. In rheuma- 
tism, where the digestive apparatus is in good working order, eat as 
many boiled asparagus as you wish, make a whole meal of it, and 
probably your rheumatism will leave you without much, if any, medi- 
cine. 

Dried beans, peas, lintels, are very nourishing to the healthy, but 
next to poison in sickness. 

It is hoped that no reader of this book will give pies, cakes, pudding, 
or any kind ofpastiy to the sick or convalescent. It is poison to them. 

In serving the meals to your sick, great stress should be laid upon 
the matter, how it is served. 



SICK CHAMBER. 85 

1st. Cleanliness of food and the dishes it is served on is necesssary 
to give your afflicted an appetite. 

2d. Always make it tempting to the eye. Have your toast a rich 
yellow, your tea of good color and flavor, your cream sweet and fresh; 
the water crystal clear, even if you have to filter it through sand or 
felt; a clean napkin with every meal. If the patient has a liquid diet 
serve only a half plate at a time, or so much as you think he or she 
will eat, or even a little less. If they want more, he prepared to give 
it to them, but allow no gorging* In case meats are permissible, 
garnish the dish with a sprig of parsley or celery, or a few slices of 
lemon. It will sharpen the appetite. 

3d. Always offer your sick, water after meals for cleaning the mouth 
and lips, so that they will not have the after taste too long. 

4th. If the patient cannot get up for his meal, serve it to him in 
bed, make his position there one of comfort by proping pillows or 
blankets at his back. If too weak to do this, let him take his food 
in a recumbent position, in liquid form, administering it through a 
straw or glass tube, or in the shape of a nurse bottle. The latter 
mode of taking food is of much value where the patient suffers with 
much pain in bones, joints and muscles, where every little movement 
causes annoyance. Often this class of sick would rather be without food 
than undergo the torture caused by being moved and propped up. 

5th. The meal must be ready to the minute when the sick expect it, 
if you fail in this the patient will lose his appetite. 

6th. Under no circumstances talk to your sick while they are eating, 
and discourage their conversation during meal as much as possible. 

7th. After meal, darken the sick room slightly and allow your sick 
all the quit rest or sleep they wish. 

The Sick Chamber. This should be the best room in the house and 
many a mother will sacrifice her parlor for this purpose, if she knows 
that it will contribute to the betterment of her sick child or husband. 

To place a sick person in a sick room, when no direct air can get 
into it, or where sunshine, the light of life, can throw its beneficient 
rays, is a crime. In this enlightened age no one would think of 
building a hospital, where air and light cannot penetrate and for good 
reason. Therefore, if you have sick people, whose sleeping apartment 
are close and stuffy, remove them to a better place. Ventilate the 
room, even in the coldest weather, protecting the patient, while doing 
it, with screens or covering. Keep the temperature even between 



80 CONDITION OF THE BED. 

63 ° and 65° F. Prevent any and all kinds of dust in the sick 
room. Have the room properly disinfected, at least every twenty- 
four hours, by means of a solution of sulphate of iron in water placed 
in a vessel under the bed. Clean the room twice daily. Have your 
eye on the stove, if you burn coal, that no gas is escaping. Smoke is 
also injurious. 

As to atmosphere, a good many sick chambers can even to-day, be 
recognized by means of the nose, instead of seeing the sick. Prevent 
the bad smell by ventilation, cleanliness and disinfection. If the air 
becomes too dry, evaporate some water in room, do so also when too 
warm. This is especially necessary in lung diseases. 

Bed and Clothing. A hair mattress, or in its absence one of moss or 
corn husks is the best, covered with an old but clean blanket and cot- 
ton sheet. For covering next to body cotton sheet in summer and 
woolen in winter and such number of clean dust-free woolen blankets 
or spreads as may be necessary, constitutes, with feather or hair 
pillow a good bed for any sick person. The bedding should always 
be scrupulous clean and be aired every day. Warm them before 
allowing their contact with patient. As body clothing a long woolen 
or cotton night gown serves its purpose best. Never use covering or 
clothing to such extent as to cause perspiration. Never keep the 
stockings on patient while in bed. Always tuck the covering down to 
prevent draught. Change night gown and sheet twice a week. Bed- 
ding and clothing soaked with perspiration, blood or pussy matter is 
poisonous to the sick. Have the room in proper temperature and 
doors and windows closed when changing the bed clothes. 

Wash your sick three times daily and do not neglect to comb the 
hair. 

To regulate the occupation of the sick is about the hardest job for 
the nurse. The old theory for the sick to occupy his mind with 
nothing and get well in consequence, is blasted long ago. 

Many sick do not need or cannot partake of any occupation or con- 
versation and pass their time in a comatose state; it is these, how- 
ever, who need the most careful watching. Has it not happened, 
that the patient died without the knowledge of his nurse ? To such 
sick you must offer nutriment at regular hours, moisten their mouth 
and lips as well as nose, and allow them to smell on a rag soaked in 
much diluted vinegar. See to their stool and urinating. Watch that 
they do not become bedsore. Do not raise the head too high. It 



CAEE OF THE SICK. 87 

will facilitate the flow of blood to the brain. Do not allow the 
patient to bury his mouth and nose in the pillow, it obstructs breathing. 
Do not allow any noise about the sick chamber, it will irritate the 
patient. The pushing of chairs on bare floors, the slamming of doors 
in house, squeeking of doors, rattling of windows, flying about of 
shades and curtains, all lead to a like tendency. Do not show anxiety 
oh your face, have no whispering conversation with any one, not even 
with your patient, as it strains his ear nerves; it is also liable to raise 
distrust in the mind of the patient as to his condition. The noiseless 
walk of the nurse, the apparent endeavor to be more than attentive 
towards the patient, brings hallucinations to his mmd, which bring 
no good. 

If the patient desires to converse with you, show him always your 
face, in a sitting posture on a chair adjoining the bed, as this prevents 
the cramping of his neck, should you stand alongside of him. Never 
sit on edge of the bed, as your weight on same, cause disagreeable 
movements to the patient. Give all possible information to your 
patient, but do not sympathize with him, as he might imagine him- 
self in a worse state than he really is. In the administration of medi- 
cine be firm and prompt and do not listen to talk of bad smell or 
taste of same; else, through kindness of word and action, you increase 
the mental sufferings of the patient. Never allow your charge to become 
impatient, - always soothe him with kind words, when you have to 
leave him for a few minutes. 

As the patient regains strength, the work of nursing and watching 
becomes easier, but even then we must not leave the stages of conva- 
lescence to his judgment. He will mistake signs and try to force his 
convalescence; he feels strong in bed and wishes to leave the same and 
does not consider how he saves his organs, by their inactivity, in bed. 
In bed he can keep the normal animsl heat a great deal easier than 
out of it, and even in a warm room with warm clothing, the ill signs 
of a chill will appear, and the patient will sink lower than he was 
during any stages of his illness. The rising from the sick bed should 
be gradual, short spaces at the beginning, and be increased in pro- 
portion as the wasted body regains strength. 

Especially after child birth, when the young mother imagines she 
has regained all the strength lost during her confinement in bed, and 
is anxious to rise, she becomes dizzy and falls into a swoon, as soon as 
she is raised up. Be careful; grim death is only masked by the child 
bed fever, and is looking for a victim. 



88 REGULATING THE STOOL. 

A great many sick, when weak in body, imagine unimpaired mental 
faculties ; this is of ten the case in the first stages of convalescence, 
For this reason, the nurse, by word and action,' must omit everything 
which might give rise to mental excitement. Real mental work must 
only be done by the healthy. The patient should only be allowed to 
read in bed, where he can be bolstered up, and has the best of light. 
Eeading to a patient must not be too long at any one time. As to 
the quality of the literature, it should only be of the most moral tone, 
and nothing - be in its contents which calls forth mental digestion or 
deep reflection. At sleeping time the patient should not be molested 
with unnecessary kindness and be allowed to collect his thoughts 
preparatory to a good night's rest. A useful and agreeable occupa- 
tion for the sick is the looking at pictures of all kinds. 

The real useful nurse is always more influenced by the signs of the 
disease than by the wishes and exclamations of the patient, and one 
who becomes confused in her judgment by the latter, is a bar to an 
early recuperation of the patient. The nurse's head must remain as 
clear as that of a General in a battle, she must not waste her strength. 
The display of ^anxiety and care has never saved the life of a patient, 
but a jovial temperament and a hopeful face, have fooled death oftner 
than once. 

Regulating the stool. This needs special attention and many a time 
symptoms of disease make their appearance, which scare the whole 
household, and in reality nothing is the matter with the patient but 
constipation. So when you find that you cannot regulate the stool 
by dietary means, resort to rectal injections, by means of a syringe, 
first using luke warm water, if that does not bring it, add a little pure 
castile soap to it. If the patient has pain in rectum, or ulceration, 
use thinly boiled starch for the glyster, it has a soothing and healing 
effect. In adjudging the nozzle into the rectum be always careful and 
wash it first with a little carbolic acid, bottle No. 5, and then grease 
with some vaseline, bottle No. 14. Let the fluid ascend slowly into 
the rectum and keep it there as long as possible to give the water a 
chance to dissolve the putrid, solid mass lodged in the large intestine. 

Soap plugs are very useful to hasten the stool ; take of common 
white laundry soap and whittle a piece about three inches long and of 
the thickness of a pencil, lubricate it with some sweet oil and insert it 
into the rectum. In the average case it is infallible. 

"When a patient is too weak to go to the closet, or cannot assume 



ADMINISTRATION OF MEDICINE. 89 

the sitting posture necessary iu the use of a night vessel, you must 
procure the wedge-shaped bed pan, warming it gradually, and shoving 
it gently under the sufferer. Never be neglectful in this duty, and 
while perhaps disagreeable to some, consider it a daty you owe your 
fellow being, and that at sometime you may be in a position where you 
need like service. 

In a great many diseases, where your knowledge of the case is not 
sufficient and you need the experience of the family physician, it will 
be necessary to examine the urine, and in such case always have the 
patient use a glass if he can sit up to do it, and if not able use a large 
necked white glass bottle. The latter will also be necessary for ordi- 
nary urinating, when the patient cannot undergo the exertions incident 
to the use of the chamber. 

In the administration of medicine be careful and see that the patient 
does not lose half of it. The tea and table spoon are good measures, 
but not so well adapted for the administration, a cap is preferrable. 
Liquid medicines containing iron or other injurious ingredients to the 
teeth, should always be taken through a straw or glass tube. 

Powders are best taken dry and washed down with a swallow or 
two of water. If taken in a wafer, roll the powder in same, moisten 
the wafer, place it in a teaspoon and swallow with a draught of water. 

Inhalations of vapors should be made over the vessel containing 
the medicaments. \ 

Ointments should be well rubbed in and in case the patient is sore, 
spread the preparation upon a rag, about the thickness of the back of 
a table knife and apply it like plaster. 

Plasters should only be stuck on the body after carefully washing 
and drying the afflicted parts. 

"Washing, bathing and the rubbing down with course towels is a 
good thing for patients in nearly all stages of disease, and keeps the 
skin clean and fresh and in a measure replaces the exercise the body 
is otherwise subjected to. The gradual use of cold water on afflicted 
parts will strengthen them and prevent the taking of cold, 
when the patient leaves the bed or goes out. His body has through 
these washings become hardened and fortified. 

These ablutions will not only excite to activity the skin, but also 
the respiratory organs, the actions of the heart, and the nerves. It 
also exercises a secondary influence upon digestion. 

When patients cannot partake of any bodily exercice, it is well to 



90 DISINFECTION. 

resort to massage, as it replaces in a measure the activity in a healthy 
body and so needful to it. Massage is a kneading and rubbing . of a 
body by means of hands and in doing so, the operator should always 
lubricate his hands with a little vaseline, bottle No. 4. Massage is 
very good when the blood is not in a healthy state of circulation, or 
when the patient is bothered with wind in the abdomen. Commence 
gently and increase your activity as the patient becomes used to it. 
He will soon learn to like it. 

Active and passive gymnastics are of value to the patient and have 
similar effects as washing and massage, only differing that the person 
performs the operaiion himself. The raising of the body by using 
arms as props, voluntary turning in bed, kicking w 7 ith legs, or rub- 
bing and clapping of the hands, all have good consequences and 
bring the sluggish blood and nerves mto activity. 

The patient can do nothing better for himself than exercise his 
lungs, by deep breathing of pure fresh air, and if he does it not of his 
own free will, he should be asked to practice these lung gymnastics. 
He and you will notice, after a little practice of this kind, that sighs, 
gasping, and the consequent anxiety of the surrounding friends will 
vanish, the appetite of the lungs having been satisfied. The inhala- 
tion of pure fresh air in large quantities, in fact the gorging of the 
lungs with it, wall also have a tendency to drive away the pale com- 
plexion, the cramped convulsion of the face, the dullness in head and 
restore the lustre to the eyes. 

Disinfection is a matter of necessity in the sick room and is best 
done by pouring a few drops of carbolic acid, bottle No. 5, into a 
vessel containing boiling water. The vapor of it will do the work 
very effectively t After a patient has left his sick room, it is always 
advisable to burn a little sulphur, Bottle No. 15, in the room, having 
all doors and windows properly closed and allowing these sulphurous 
vapors to penetrate to any and all parts, by which, germs of disease, 
if they are in existence are killed. During this process the bedding 
and clothing of the sick should remain in the room and be dusted 
and brushed after the sulphur bath. 

Articles of little or no value, having been in use by the patient, 
should be burned. 

The clothing of the sick, before being mixed with the family wash- 
ing, should be well boiled in soap and water. 

Always disinfect the water closet with oxide of iron or carbolic 



EFFECT OF MEDICINES. 91 

acid, never use chloride of lime, as its fumes are hard on the lungs. 
In case you have no sewer connection, you can use ashes and sawdust 
or sand moistened with carbolic acid in the disinfection of closet 
vaults. 

Chamber vessels, urine bottles and glasses, cuspidors, or anything 
used as a recptacle for solid or liquid excrements, should be cleaned 
thoroughly at least once every day, and a little lye, be used in doing 
so. If spittoons are used containing sand or sawdust, put a few 
drops of carbolic acid, bottle No. 5, in the same. 

In disinfecting the chamber vessel be careful to wipe the rim so that 
all acid is removed, as the contact with it to the sexual organs is irri- 
tating. 

If you have a corpse in the house be watchful that the undertaker 
uses proper disinfectants, and if he neglects call his attention to the 
matter. If the funeral director understands his business he has prop- 
er ingredients at hand to cause the necessary disinfection of the 
corpse and its surroundings. The room where a corpse lies prepara- 
tory to its burial, should not contain any furniture, as it might be 
the conductor of germs to others. After burial the room should be 
carefully sulphured, aired before it is used for habitation. 

The Effect of Medicines and Remedies applied must be observed, and 
no rule can be construed which would be applicable in general. 
When medicine has been administered we have a right to expect 
betterment in the condition of the patient, but if we fail to notice any 
improvement, it is not a sign by any means, that the remedy applied 
has not done its duty. Different causes may obliterate the beneficial 
effect and the main of these is a wrong diagnosis of the diseases, and 
it is especially necessary for this good reason, this good reason, that 
any one, becomes thoroughly acquainted with the human body before 
he attempts to alter its functions. 

Another reason is impatience, or to expect good results before due. 
Eemember that the majority of medicines taken internally are brought 
to action by the blood and that takes time especially so, when the 
assimilation is of a slow nature. 



Diseases. 

THE ORGANS OF SENSE. 

THE EYE. 

ITS CARE: It consists mainly in not using the eyes when we 
notice the least difficulty with these organs. To forstall this,is to 
use the eye, but not misuse it. When you use your eyes till 
they pain or burn, you hurt them, and this you will find to be the 
case in diseased eyes at an earlier period. As soon as you notice any 
tiredness, your occupation must be changed, when the eyes will not be 
called upon to do any work. Also long duration of use of eyes in fine 
work, reading by bad artificial or twilight will weaken your optics 
very rapidly. The light you use should not be too strong, but sufficient 
to distinguish at ease fine delineation. The position of the head 
must facilitate the flow of blood to this organ and when you bend 
sidways or forward too much you will cause an interference. Costive- 
ness, the use of alcoholic or malt beverages, strong tea or coffee have 
influences derogatory to good sight and must be eschewed in eye 
troubles. Pure air, free of dust and smoke, is essential for the pre- 
servation of the eye. A strong wind if direct into the eyes has a tend- 
ency to inflame them. 

If your eyes are afflicted in any shape, do not bury your head at 
night in the pillows, or put such bandages over them that no air can 
get at them. Protect the eyes against too strong light by shades over 
lamp, or over your eyes. Those of green color are the best. If this 
will not darken the burning sensation darken the room you occupy. 

Bandages for eyes in case of severe cold should be made as follows : 
Take of old worn linen, strictly clean and free of starch, and cut oval 
pieces about the shape of the eyes, and large enough, so that the 
edges just touch the long projections surrounding the eye, moisten 



SWELLING OF THE EYE LIDS. 93 



the rag with pure water and lay it over the closed lid, than fill up the 
cavity with clean cotton fibres or linen shreds, cover the whole with a 
square piece of linen from the eye brows down to the root of the nose 
and fasten the whole by a thin gauze bandage around the head. 
This bandage should be changed every twelve hours. 

If your eyes cannot endure the sharp sunlight, wind or dust use 
blue or smoke colored gaugles with wire gauze at sides. Use these 
glasses always in the shape of spectacles and not by means of fasten- 
ings to the nose. 

If you use glasses habitually or temporarily see that they are clear 
and free of stralets. 

The best medicines for the external applications are clear watery 
substances and a bandage. Never use salves or oily medicines for this 
purpose, they become rancid and gather dust. 

Eye poultices can be applied cold, luke warm and hot, as the circum- 
stances may require. Ice is best applied mixed with salt, in a tight 
rubber» bag, or pig's bladder. If you use rags for this kind of poultice, 
leave out the salt. When poultices are necessary the patient should 
lie in bed or at least dn a lounge. To apply poultices and keep them 
in place by holding, is more harmful than good. 

When tears, mucus or pus run from the eyes remove the poultice in- 
stantly to prevent spread of inflammation. Bathe in such cases the eyes 
and surrounding in luke warm water and dry them carefully after the 
ablution with a clean towel. After drying apply a small quantity of 
vaseline, Bottle No. 14, and keep out of the dust. 

Swelling of the Lids. Liable to happen in tooth-ache and eczema, is 
of little consequence, bath the lids frequently in cold water, keep out 
of draught and dust, and do not use the eyes at all. Too much light 
is harmful. In scarlet fever, the eyelids are usually swollen in the 
morning, but will leave during the day, it is a sign, however, of in- 
flammation of the kidneys. In such cases gather the urine and sub- 
mit it to the family physician for analysis and follow his course. 

Sty, forms on the edges and mostly at the ends of lids, and consists 
of an inflamed swelling or boil. Usually a number of these small 
abscess form one after the other and must have their course. 

Treatment. Clean carefully the edges of lid and moisten by means 
of a camelhair brush, or very soft sponge, the affected parts with 
one part of 10% carbolic acid, C. P. Bottle No. 5, 
ten parts of pure rain or strained well water. 



94 CATARRH OF THE EYES. 

Apply about every 3 hours, give a speeial cleaning and application 
before retiring. Keep out of wind and dust, and do not bandage the 
eye. 

Inflammation of Lid Glands. The edges of lids become red, around 
the lid, hair or lashes form yellow crusts, in aggravated cases little 
pits form on edges of lid, the hair or lashes are bent; causing 
irritation to the eye; and fall out. Swelling of the lid from the inside, 
turns the edges up causing irritation of the eyeball. 

Treatment. Same as sty, and pull out all hair coming in contact 
with eyeball, and wear blue or smoke colored gaugles. 

Paralysis of upper lids and difficulty of closing same, is an important 
sign in nervous diseases and will mend with the recuperation of the 
nerves. 

Treatment. Eest, cold washings, and a nerve strengthening diet. 
Coffee, tea, alcoholic liquors, tobacco must be abolished. Much 
exercise in open air with no mental exertion. 

Cramps of the Eyelids, is a sign of overwork. Wash your eyes every 
hour in luke warm water. Take a rest and prevent the entrance of 
foreign bodies. 

Involuntary jiow of tears, is a nervous weakness of the tear ducts and 
sometimes accompanied by inflammation. It often happens in cases 
of nasal catarrh. 

Treatment. Same as in, case of sty, frequent washing. Use no 
coffee, tea or liquors. Leave off smoking. 

Squinting is a disorganization of the muscles moving the eyeball. 

Treatment. To effectively cure requires a careful surgical opera- 
tion and our advice is to consult a first-class oculist. 

Catarrh of the Eyes. Consists of reddening, swelling and heat of 
the inner mucous membrane of the lids and can be best seen, by pres- 
sing against the under portion of the lower lid and looking into the 
cavity formed between eyeball and lid. It commences with a burning 
and itching sensation, with formation of mucus arid pus, which 
nearly closes the lids owing to the adhesion. Children thus afflicted 
will rub their eyes, causing increased inflammation. Strong light is 
painful to the eye. If not counteracted in season the inflammation 
may spread to the eyeball. 

Treatment. Keep out of dust, in slightly darkened room, at an 
even temperature. Bath eyes every hour in luke warm water, and 



INFLAMMATION OF THE EAE. 95 

prepare the following: Take 3 ounces white oak bark, next to tree, 
and boil in one quart of water to about one pint, strain till perfectly 
clear and free of all hard substances and till it looks like medium 
strong tea, add to this 3 teaspoonfuls carbolic acid 10%, C. P. Bottle 
No. 5. Shake well and saturate clean linen rags, free of starch and 
dust, with the mixture, and lay on the aflicted parts. The mixture 
should be of a temperature of 75 ° F. when applied. Use the rags 
only once, or if you run short wash them thoroughly before using 
them again. The patient is better in bed or on lounge, than sitting 
around on chairs. Usual diet but avoid fats, tea, coffee, and liquors 
of all kinds. Have a separate wash bowl for the patient, also sponge 
and towel. See that the hands of the sick are always strictly clean 
and that the finger nails are properly trimmed. 

In the least tendency to catarrh or granular inflammation of the eye, 
Diptheritis is liable to settle in this organ, by mere contact with the 
patient or receiving the exhalations of breath. Too much care cannot 
be exercised in attending sufferers with diphtheritis and often in the 
space of a few hours this contagious disease has spread to the nurse 
or surrounding friends, and by preference settles in the eyes. In such 
cases, the eyelids swell rapidly, assume a blue red color, become hard 
to the touch and matter is emitted from between the layers of the lid. 
The pains in the lids are excruciating and spread towards the fore- 
head and temporal regions. Fevers usually appear. The eyeball 
being in such close contact will become diseased in consequence and 
little hope can be entertained to save the sight of the organ thus 
afflicted. If only one eye catches the disease close the other one and 
cover it up carefully with a bandage as heretofore described. 

Treatment. Mal^e a poultice of very finely chipped ice adding to it a 
small pinch of borax, Bottle No. 3, enclose the whole in clean linen 
rags and apply to afflicted eye. This will effectively check the spread 
of the disease, till you can call in professional aid. The fever does not 
require special treatment. 

Bloodshot. Notwithstanding the dangerous appearance of this 
common disease, it is connected with no danger whatever, and 
will soon right itself if you rest your eyes and use blue eyeglasses for a 
time. It is painless and does not interfere with the sight. In chil- 
dren it happens often, when they have whooping cough, or in sneezing 
and vomiting. Apply cold water. 

Foreign substances between lids and eye-ball cause excruciating pain, 



96 THE EAK. 

which is much increased through the action of strong light, and, if the 
matter is not removed, may lead to cramps in the eye lids and inflain- 
mation of its mucous membrane. 

Treatment. Attach a very small piece of sponge, to a stick or small 
quill, moisten it in luke warm water and sweep with it under the lids, 
till the cinder or whatever the object may be is removed. If pain still 
exists or irritation calls for rubbing, apply cold water poultices on 
afflicted eye. Young children, having foreign substances in their eyes, 
are usually very obstinate, and mothers can easily convince them 
with a firm kindness that something has to be done and while kissing 
the little one can slip the tip of the tongue under the eyelids and push 
out, without pain to the child, the matter therein lodged. The 
mothers, by their fine sensibilities in the tongue, will also know 
whether they have been successful or not. 

Disease of the cornea is frequent and especially so in scrofulous 
children this disease has a tendency to obliterate the trans- 
parency of the cornea and thereby cause blindness, it is advisable 
to consult an oculist as soon as vision is interfered with and from ap- 
parent obliterations of the function of the cornea. 

Diseases of the internal portion of the eye require special treatment 
by an oculist, not even the every day family practitioner ought to be 
consulted, but the best talent which you can reach, you will find to be 
the cheapest in the long run. 

Flickering before the eyes, is often noticeable in fever, poverty of 
blood and rush of blood to the brain. It is an irritation of the optic 
nerves. The disagreeable feeling will vanish, as soon as the cause of 
it is removed, which you will find treated under their specific heads. 

Color blindness is sometimes a hereditary disease, but more fre- 
quently it is caused by the minute nerve fibres which can not be excited 
to their proper function. It is simply a paralization of those nerves, 
which serve to distinguish color. There are no remedies which will 
cure this ailment. 

THE EAK. 

Its care. The first principle in disease of this organ, is to keep it 
perfectly clean, not only on the outside or visible portion, but also the 
auditory canal. This is best effected by means of a syringe and the 
use of lukewarm water with small particles of castile soap disolved 
therein. Application of heat is also often necessary and this is best 



FOKEIGN SUBSTANCES IN THE EAE. 97 

accomplished by cotton layers. Medicine, if liquid is allowed to fall 
into the cavity by dropping and powder forms are blown into it by 
means of a twisted paper tube or goose quill. 

In neglected disease of the ear, when pus comes in contact with skin 
of head and neck supuration is liable to set in. The places should be 
carefully washed with soap and water, the syringe should be used in 
the auditory canal, taking lukewarm water, adding to it a few drops 
of carbolic acid 10% C. P., which you find in bottle No. 5. This 
carbolic wash should also be applied to adjacent parts. After drying 
all afflicted parts, use a little vaseline on same. Bottle No. 14. 

In ear diseases, the adjacent glands also become affected and fre- 
quently become inflamed and go into suppuration. Inflammation of 
the surrounding bones may also occur 

1. Bloody swelling on external ear are painless and very seldom 
become inflamed. 

Treatment Soak linen rags in cold water, wring them out and 
apply. When they become warm make new application. 

2. Frost bites are of frequent occurence. To prevent same put 
small particles of cotton in auditory canal and apply to external part 
a little vaseline. Bottle No. 14 or wear ear protectors. 

Treatment. As soon as you notice that your ears are frost bitten, by 
being insensible to touch and rather rigid, apply snow or clipped ice, 
till they are thawed. This must be done in a cold room. Do not in- 
crease irritation by rubbing. Apply vaseline. Bottle No. 14. 

Ear wax. It often accumulates to such extent that deafness seems 
to approach. 

Treatment. Clean the auditory canal thoroughly by means of soap 
and lukewarm water, using for such portions as you cannot reach the 
syringe. Small particles of the wax become loosened and will be 
easily removed. Never use stick or hairpin. Grease internal ear 
with a bit of vaseline. Bottle No. 14 and keep cotton in ear for 4 or 
5 days. 

Foreign substances in ear. Insects and small hard substances. Peas, 
Beans or Corn, often placed by children in ear and cause swelling. 

Treatment. For insects and small substances, use syringe and luke- 
warm water. For other substances place child on side, where afflicted 
ear is located. The kernel will gravitate towards the opening, then take 
hairpin, bend it slightly at crook, get behind the object with it, and 



98 EAR ACHE. 

remove with a jerk. Another way is to get hold of the object with a 
pair of tweezers or scissors and remove obstacle. 

After removal use syringe with an injection of 
10 parts lukewarm water, 
1 part 10% Carbolic Acid C. P. Bottle No. 5. 

Fain in Ears. Occurs often and afflicts the whole side of face, it does 
not interfere usually with the hearing. The external ear is usually 
somewhat reddened and the parotid glands in front or ear become 
swollen. 

The patient is usually very excited and appears to have inflammation 
of the brain. To touch, the sufferer seems to be slightly feverish. The 
pulse slow and irregular. In these symptoms use the following 

Treatment. Take one good sized onion and grate it, and squeeze 
all the juice from the pulp add to it a like quantity of lukewarm 
water and 20 drops of carbolic acid 10% c. p., bottle No. 5, saturate 
cotton with the mixture and apply. 

Catarrh of the ear is usually transplanted from the nose through the 
eustachian tube. 

Treatment. Wash the affected organ with hike warm water and 
castile soap, using the syringe to reach the inner parts. 

Discharge of pus from ear, is a[sign of an aggravated disease of the 
hearing apparatus and can lead to complicated troubles, but if noticed 
and cared for in proper time, will yield to the following 

Treatment : Keep the patient in an even tempered room of about 
70 ° , letting in pure air quite frequently. Clean the ear of all pus by 
means of luke warm water and castile soap, then make an ear wash 
as follows : 

Pure luke warm water, 50 parts (say 50 teaspoonfuls) 10% carbolic 
acid, c, p., bottle No. 5, and of borax one part, bottle No. 8, mix well 
till borax is dissolved, and inject same, by means of a syringe, imme- 
mediately after the cleaning process. Then take some dry borax, 
bottle No. 3, and blow it into the affected organ by means of a small 
paper tube, twisted for that purpose. Eepeat four or five times a day. 
During intervals place a little cotton, saturated with arnica, b6ttle No. 
12, in ear. Place on outer ear a little vaseline, bottle No. 14, also on 
neck if any pus should have fallen on same. 

Dizziness of head, humming and buzzing in the ear. This arises from 
.congestion, or too great amount of blood about the organs of hearing. 



DEAFNESS. 99 

It may also be the result of nervous debility, and there is no relief 
but in the removal of these difficulties. 

Deafness. If constitutional there is but little relief, even the most 
accomplished artists fail to rebuild an organ entirely destroyed. If 
deafness is caused by an accumulation of ear wax, proceed as explain- 
ed under that head. If the result of cold or catarrh apply the follow- 
ing remedies. 

Treatment; Keep patient in an even tempered room of about 70 ° , 
under good ventilation ; the best place for him is where there is no 
noise, or where he is not exposed to excitement, then take two good 
sized bulbs of garlic, or if you cannot get them, take one large onion, 
grate and press juice 'from pulp, add to every tablespsonful 5 drops of 
carbolic acid 10% c. p., bottle No. 3, and 5 drops tincture of arnica, 
bottle No. 2, mix thoroughly and strain through fine white cloth so 
that the mixture is free from all solid substances. Heat a teaspoon 
in hot water and by means of it drop 4 to 5 drops into each ear, clos- 
ing the same with clean cotton. The mixture when applied to the 
internal ear should be about body heat. 

The above is a specific in deafness caused from cold. 

Temporary deafness, caused by catarrh, is usually relieved with the 
catarrh when it is cured. 

All the complicated diseases of the ear should have the attention of 
a speciatist in ear troubles. 

Diseases causing the temporary elimination of smell and taste are 
symptoms of nervous diseases and not, as a rule, local affections 
of the nose and mouth. The troubles are deep seated and the nerves 
which preside over these senses are, owing to the diseased condition, 
unable to discriminate. These ailments usually cease when the 
nerves resume their proper functions. 

The skin , as an organ of sense, often offers signs of diseases of the 
nerves, and this is the case when touch or sensibility to heat or| cold 
is blunted. Among the symptoms which we have in these troubles 
are shivering, burning sensations and severe pain. Contractions of 
the muscles and cramps are symptoms of the more aggravated cases. 
In the begginning there is usually an increased secretion and flow of 
tears and saliva. Pain in the face occurs often of such severity that 
the patient becomes senseless and it has been known, where the poor 
sufferer was not carefully watched, that suicide has been resorted to. 
If these pains are not properly checked, they may migrate to the 



100 NEURALGIA. 

brain and cause complication of diseases which are hard to control. 

The most common form of nervous affections of the skin 
and muscles is known as 

Neuralgia, which may be caused by taking cold, bodily and mental 
exertions, improper nourishment and general nervous debility. It 
may appear in nearly every part of the body. 

Symptoms : In neuralgia we may distinguish two forms of pain. 
One continuous, increased by pressure and confined to circumscribed 
points in the course of the nerves ; not very severe but annoying pain ; 
the second appears in paroxysms, spreading from a point along the 
course of the nerve, the pain is terrible and almost unbearable. 

At the commencement of neuralgic attacks we see occasionally that 
the skin becomes pale, and during the height of the attack, that it 
reddens. 

In cases where neuralgia is caused from malaria it is of a temporary 
nature, otherwise it should be considered a chronic disease. 

Slightly touching the skin, as in caressing the patient, often ap- 
pears to induce attacks of pain more readily than heavy pressure does. 
Movements of the parts where the pain is located, namely, chewing 
when neuralgia is in the face, walking when in leg, and especially 
when the sciatic nerve is troublesome, coughing or sneezing when 
chest is affected, all excite attacks of pain. Mental excitement some- 
times has the same effect. Each attack of pain usually lasts only a 
few seconds, but these short attacks are often repeated several times 
in the course of one or a few minutes, and then cease for a while so 
that in fact we may say, that in neuralgia long attacks occur which 
are composed of a number of short fits. 

Neuralgia may continue for many years, except in the cases caused 
by malaria, or the so-called rheumatic neuralgia. 

Care. In all neuralgic affections the patient should be extremely 
careful not to aggravate the already troublesome malady by contracting 
cold. Except in warm weather he should keep in the house and in bad 
cases, keep in bed. Special care should be taken, where the patient 
is indoors, to have the air changed and that it is pure at all times. 

The diet of the patient should be one of the most nourishing 
character, and at the same time an easily digested one. Care must 
be taken that the afflicted has a regular stool, and in case of costive- 
ness, counteract same by giving the patient stewed fruit, not too 



SICK HEAD ACHE. 101 

sweet, at every meal lemonade, and allow him to suck a peeled lemon, 
oranges are also beneficial. 

External applications, such as strong blistering, ointments, mustard 
plasters and similar irritants, should only be used when especially 
prescribed. When these remedies are used injudiciously they may 
cause inflammation of the affected nervous tissues, which would lead 
to greater trouble than neuralgia. 

In neuralgia ot the gums do not pull the teeth, it will help but 
little, and very often the wrong tooth is extracted. 

Patients suffering with any kind of neuralgia are very irritable, 
often a fly on the wall will throw them into paroxysm. Humor them 
all you can, be their requests ever so unreasonable. They require 
rest of body and of soul, and the easier you make it for them to ob- 
tain it, the less will be their excruciating pain. Darken the room 
where the sufferer lies. Do not allow any kind of noise in the sick 
chamber, and see to it that it contains fresh air of an agreeable 
temperature. Avoid all stimulents and spices in the patient's diet. 
Kemove from the sufferer all tight fitting clothes, and do not weigh 
Mm down with too many blankets or quilts. 

Xeuralgia having been caused by malaria succumbs easily to the 
following treatment : Give the patient at night one pill, cathartic 
comp. (vegetable) ; two may be given where stool has been very la- 
borious for some days. Bottle No. 17. 

Next morning after stool has been made give the patient one quiniae 
sulphatis, 2 gr., bottle No. 16, repeating the dose every two hours 
untill 2 p. m. Avoid mental and physical excitement. 

Sick headache, migraine. The symptoms of this ailment are difficult 
to explain, and it is even doubtful whether it belongs to the diseases 
classed as neuralgia, however it is universally done. It usually occurs 
in one side of the head, it often begins in childhood and remains till 
old age. It is not a permanent disease and attacks the body only at 
long intervals, showing a steady increase and diminuation of the pain, 
but never an instantaneous occurrence or disappearance. Perhaps in 
half of the women affected with nervous headache, the attacks occur 
at the menstrual period or immediately before. Some women suffer 
with it on day after attending reception, theatre, or other exciting 
occurrences. The cause of it is usually impediment in digestion. 

Treatment: Keep in a quiet, darkened room, avoid all excitement 
and exertions, keep the bowels open, and if it cannot be done by a 



102 NEURALGIA OF FACE. 

diet of fruit containing acid, use a rectal injection of luke warm 
water and a little castile soap. 

In case the malady occurs in time of menses, take two tablespoon- 
fuls of green coffee (unroasted) and boil same in one quart of water, 
down to one pint, strain, cool and take, for two or three days before 
mensturation, or during same, every three hours, one or two table- 
spoonfuls of the decoction. 

Neuralgia oiface and back of head is of veary frequent occurrence. 
It is seldom caused by foreign bodies under the skin or tumors press- 
ing against the afflicted nerves. It is usually caused by catching cold. 
It is seldom in childhood, but more frequent between the 30th and 
50th years and more common in women than in men. The pain is 
intense and the attacks are often accompanied by a watery discharge 
from the nose. During the attack the face is usually reddened, the 
temperature increased and the pulse is very active. 

The duration of the disease is seldom short, except when it is 
caused by malarial affection. Among the terminations besides, 
complete recovery, severe melancholia occurs, which may drive the 
patient to suicide. Death results very rarely from this disease. It 
may cause disfigurement of the face. 

Treatment. Keep quite as described before, apply linen or cotton 
cloth saturated with ice water or chipped ice between layers of cloth. 
At intervals when pain is relaxing apply friction by means of a brush. 
See that the bowels are open and give of Pill Quiniae sulphates 2 gr., 
Bottle No. 16, every two hours till 2 p. m., never after that hour. 
Diet must be nourishing but easy to digest. 

If above treatment fails give of Phenacetine-Bayer, 2 grains, Bottle 
No. 23, one pill every two hours, but not more than three pills in any 
one day, No case is known where two doses have not effected a 
cure. 

Neuralgia in Chest, also called intercostal neuralgia is the morbid ex- 
citement of one of several spinal nerves, especially those, which, as 
intercostal nerves, pass along the upper spaces between ribs to the 
breast bone and along the lower spaces in the stomachial regions. It 
is one of the most frequent forms of neuralgia, and more in the female 
than the male. It often occurs after recovery from pleurisy and is 
often an accompaniment of tuberculoris of the lungs. Women of a 
hysterical nature and having chronic womb troubles are also usually 
afflicted with this form of neuralgia. 



NEUBALGIA OF THE HIP. 103 

Treatment. In severe attacks the patient had better retire to his bed, 
taking care that his room is well ventilated, without subjecting him to 
any draughts. If the bowels are open give one dose of Phenacetine 
Bayer 2 gr. Bottle No. 23 and apply to chest where pain is located 
the following preparation : Take a piece of new cotton flannel and 
spread on the side which has no fibres, a thin coat of tallow, or bees- 
wax mixed with lard, either will do, and the side where the nap is, 
take of oil of mustard, Bottle No, 12, and saturate the same, apply to 
afflicted part, covering well with a piece of flannel. Keep in position 
till the skin becomes considerable reddened, and remove. Apply 
gently to the reddened spot, a thin layer of pure lard or Vaseline. 
Bottle No. 14. 

Irritable breast. It is doubtful in the world of science whether this 
disease is a neuralgic affection of the intercostal nerves, or of the 
shoulder bone nerves. Women, about the period of puberity, or from 
then to the 30th year, without any preceptible cause, become sensative 
to the slightest touch at one or more points over the mammary gland. 
JSevere pain occasionally shoots out towards the shoulder, axil or hip. 
It also happens that at the height of these attacks of pain, vomiting 
comes on. The patient cannot lie on the affected side, they are unable 
to bear the weight of the breast. The pain usually increases shortly 
before the appearance of the menses. The disease often lasts months, 
and in violent cases for a year or two without any preceptible change 
in the mammary gland. 

Treatment. Apply gently a little turpentine, bottle 13, to the afflict 
ed breast and wear any kind of soft cloth towards the skin, on the 
breast. Belief will follow in 6 to 8 hours. Keep cloth on the breast 
for 6 to 8 weeks. 

Neuralgia in the loins (lumbago) and abdominal region. 

Treatment. Same as neuralgia in chest. 

Sciatica, or neuralgia of the hip, also called hip gout, is a neuralgic 
affection of the sensory nerves of the sciatic plexus or net-work of 
nerves and causes usually excruciating and lasting pain. 

Among the causes of sciatica that leave no preceptible anatomical 
changes are excessive standing, suppression of habitual prespiration, 
and catching cold. It is quite natural that the latter should occur. 
Indeed, the majority of cases of sciatica are of rheumatic origin, as 
they result from exposure to cold of the skin covering, the sciatic 
nerve. It is not at all astonishing that the nerves most exposed are 



104 TREATMENT. 

the ones which catch cold easiest. So we have the face nerves, 
always more or less subjected to wind and weather, contract disease 
in the shape of neuralgia of the face, and that part which is necessarily 
exposed only for a short period, and usually under warm cover, is 
also easily affected when answering a call of nature and using a privy 
in which a draft comes from below. 

Sciatic is one of the most frequent cases of neuralgia. It rarely 
occurs among children, is most frequent between the 20th and 50th 
years. Oftener in males than in females. People who can use well 
ventilated and tempered water closets are seldom afflicted. 

The seat of the disease is the hip and down to the ankle ; it rarely 
descends to the foot. 

Sciatica does not begin with severity. It usually developes gradu- 
ally and slowly attains its height. The patient is never free from 
pain, but complains of its constant presence, particularly in the hip at the 
point where the sciatic nerve enters the upper part of the leg. The 
pain often begins spontaneously, especially after going to bed; some- 
times they are caused by outward pressure and movement of the 
legs. Even moderate tension of the muscles may have this effect, 
consequently the patient usually lies with his legs slightly flexed. 
Great tension of the muscles in coughing, sneezing or strangling, is 
often accompanied by severe pain* Be careful in walking, and place 
the foot of the affected side very carefully, because any quick motion 
or mishap usually causes severe pain. In chronic sciatica the limp 
which the patient favors not unfrequently emanates decidedly. In 
severe cases it may lead to paralysis. 

Sciatica is a very obstinate affection. Even in favorable cases sev- 
eral weeks usually elapses before the disease disappears and it gener- 
ally subsides as gradually as it develops. After the disease has dis- 
appeared relapse very readily occurr. 

Treatment. Upon first noticing sciatica, the patient should be given 
a warm bath, then well dried and put to bed, with woolen blanket to 
lie on as well as for covering, cotton is next best, but do not use cold 
damp sheets of any kind. Let him take one Pill Cathartic Comp. 
Veg., Bottle No. 17, and after an evacuation of his bowels administer 
to him one dose Phenacetine Bayer 2 gr., repeating the dose of last 
mentioned remedy every four hours till relieved, In slight attacks, 
ten drops of oil of turpentine, Bottle No. 13, has a remedial effect, if 
not a curative one. 



THE BRAIN AND NERVES. 105 

Neuralgia in shoulder and arm, is similar to sciatica and requires 
the same treatment. 

THE BRAIN AND NERVES. 

The thoughts and actions, other than normal are the symptoms by 
which we can recognize disorganization of the nervous system. It is 
different with diseases of the brain, than with other parts of the 
human body, for we cannot observe the changes taking place therein, 
the skull preventing it, so we have to be entirely guided by the actions 
of the body, which are controlled by the brain. The best places for 
the treatment of mental and nervous diseases are evidently the insti- 
tutions for that purpose and which are within reach of all ; private and 
pubilc. 

It is the treatment in either a sanitarium or asylum, in the earliest 
stages of abberation of the mind, that we can expect relief and per- 
manent cure, it is therefore advisable to act promptly when we see 
such symptoms among our sick. It is a moral crime to suppress and 
endeavor to take care of your mentally deranged. The institutions 
for such purposes are well prepared to care for them and the sick 
should be so informed that there is the only place from which they 
may expect relief. The treatment in the majority of institutions is a 
humane one, and the stories one hears about straight] ackets, chains, 
dark cells, corporal punishment, etc., are mostly emanations from a 
diseased mind. It is a rule nowadays to resort to the non-restraint 
system and the patient is allowed to enjoy liberty to such extent, as 
will not interfer with others. He is also induced to follow such physi- 
cal and mental occupation as is best suited him and by means of kind- 
ness is made to forget his ailment, his diseased brain rests and does 
not indulge in the many hallucinations, his mind is being led away 
from them and out of chaos comes order. 

Of course there are many diseases of the nervous system, which do 
not need treatment in hospitals or asylums, and these we will consider 

first. 

Hyperaemia or Bush of Blood to the Brain. Is caused by increased 
heart action, from too slight resistance power of the blood vessels in 
brain, obstruction in the carotid artery, paralyzation of the nerves 
regulating the now of blood, atroply of the brain and enlargement of 
the blood vessels therein. Compression of the jugular vein. Cough- 
ing, straining; Blowing instruments; Impaired function of the heart; 



106 HYPERAEMIA. 

and lastly the indulgence in alcoholic drink will cause it oftener than 
anything else. 

Symptoms. Before considering the symptoms it will perhaps be 
well to warn against the widespread error, so injurious to the patient* 
of considering all cases of disturbance of the function of the brain as 
due to rush of blood to it, or the reverse. 

Thus the disturbances which we notice in fever are not due to the 
increased flow of blood to the brain, from excited action of the heart, 
but depends partly on the high temperature of the blood in the blood 
vessels of the brain. Delerium and other severe brain troubles are 
most common in the debilitating fevers, in which much strength and 
power has been sacrificed. 

Sunstroke does not depend on hyperaemia of the brain, induced by 
the action of the sun's rays upon the head. The symptoms of this 
disease consist in a paralysis of all the functions of the brain, occur- 
ring either suddenly or gradually. In the latter case the paralysis is 
preceded by excitement, delirium and other symptoms of cerebral 
irritation. It has been determined that the action of the sun's hot 
rays is not alone sufficient to induce these severe attacks, but that they 
only occur when individuals are subjected to great fatigue, on a very 
hot day, particularly, if, at the same time, they perspire very little, 
because they do not drink enough water and too much whiskey. 

The symptoms of acute alcoholic poisoning as well as that from 
opium and other narcotics, do not depend at all, or, at any rate to a 
very small extent, on overfulness of the bloodvessels of the brain, 
notwithstanding the fact that they are congested. 

Hyperaemia or fulness of the bloodvessels of the brain is marked 
by symptoms of increased excitability, irritation and depression. 
Usually the symptoms of irritation precede those of depression, and it 
is commonly supposed that this difference of symptoms depends on 
difference of pressure on the brain from the more or less distended 
bloodvessels. Is this pressure only moderate irritation and depression 
ensues, but if strong you will notice paralysis. It is probable that the 
symptoms of depression and paralysis arise because the requisite sup- 
ply of arterial oxygenated blood to the nerve filaments and ganglia of 
the brain is limited or entirely stopped in excessive hyperaemia. In 
congestive hyperaemia the escape of venous blood from the brain is 
checked; and it is evident that, when the veins finally become filled 
to a certain point, no new arterial blood can enter the capillaries, from 
which the brain draws its nutriment. 



DIZZINESS. 107 

Among the symptoms of irritation in the sensory functions are 
headache, great sensitiveness to external impressions, etc. The 
patient does not exactly feel, see and hear more sharply than ordinarily, 
but they are annoyed by irritations far weaker than such as usually 
annoy them. Light troubles them, a slight sound, or an insignificant 
irritation of the nerves of touch excites disagreeable feelings. Morbid 
excitation causes the dazzling before the eyes, roaring and buzzing 
in the ears and sensation of an undefined pain. Among 
the motory symptoms of irritation we have restlessness, sudden start- 
ing, gnashing the teeth, crying out, the automatic movement of the 
extremities, twitching of single muscles and lastly the general con- 
vulsions, which are observed in the course of cerebral hyperaemia. 

Among the symptoms of psychical irritation there is first such 
rapid change and loose connection between the thoughts, that clear 
thinking is impossible. Along with this confusion of ideas, the 
patient has often false notions about himself and the outside world, or 
delirium. 

Delirium is sometimes so real and intense that the patient cannot dis. 
tinguish it from true perceptions. This is the origin of hallucinations 
and illusions. By the former we understand erroneous impressions, 
which are considered as the product of direct perceptions, without 
there being any actually existing external objects corresponding to the 
impression. The patients think (hey see animals and other objects, 
which are not present, and that they hear voices when all is quit. By 
illusions, we understand the misapprehension or false interpretation 
of external objects which really exist. As a result of illusion the most 
harmless things may become objects of great terror to patients suffer- 
ing from a congestion of blood of the brain or hyperaemia, and this is 
particularly the case with children. 

Dizziness which is one of the most frequent symptoms of hyperaemia 
of the brain and of many other brain diseases, is, as a rule, a simple 
hallucination, since it consists in a void representation of a movement 
of the body of the patient himself, or of the bodies of surrounding 
objects, which the patient imagine they see or feel, although they are 
actually at rest. Closely related to the symptoms of increased mental 
excitement are sleeplessness and the disturbance of sleep by vivid 
dreams, symptoms which are common in hyperaemia of the brain. 

In many cases of hyperaemia of the brain, disturbances of sensibility, 
of an irritating character, are the most prominent symptoms. Such 
patients complain of the head feeling contracted, of more or less severe 



108 SYMPTOMS OF HYPEEAEMIA. 

headache ; they are sensitive to bright light and loud noises ; have 
flashes of light before the eyes, and noises in the ears. They go to 
sleep with difficulty, and the sleep is disturbed by dreams. In severe 
cases there are often dizziness and a feeling of and similar to ants 
crawling over the extremities, The face is usually reddened and the 
pulse full and rapid. These spmptoms must not be considered con- 
stant, for in the most dangerous cases of hyperaemia of the brain, in 
those enlarged by excessive mental labor, continued night w T atching, 
etc., the amount of blood in the external organs does not at all corres- 
pond to the supply in the brain; and frequently the face is not flushed, 
but pale. Occasionally these spmptoms only last a few minutes. In 
fact, in some persons, a few glasses of wine or liquor, or some hot 
coffee suffice to induce these symptoms of congestion in the head ; 
while they remain exempt from them if they keep quiet, and avoid 
excitement. 

The symptoms of hyperaemia of the brain in children, where the 
motor disturbances are usually greatest, may very much resemble 
those of meningitis. The two diseases are often and occasionally 
they can only be distinguished by their course. Such children have 
usually suffered from constipation for a few days, have had restless 
sleep, or have been frightened out of it by dreams, which disquieted 
them after waking and prevented their sleeping again. Then there 
was vomiting and twisting of some of the limbs. These symptoms 
are often only preliminary to far severer ones, which causes great 
anxiety. They are followed by general convulsions. The twitching 
usually begins in one extremity, or one half of the face, and rapidly 
spreads over the body. The children do not respond when called, or 
when the strongest irritants are applied to their skin. They are 
bathed in perspiration ; the abdomen is puffed up, the respiration 
impaired; the saliva, made frothy by the movements of the masticatory 
muscles, flows from the mouth. Occasionally there is a pause in the 
severity of the convulsions, and we hope that the attack will pass off, 
but after a short intermission, the spasms begins again with their 
former severity, and in aggravated cases may last for hours. 

In spite of the terror that patients in this state cause the attendant 
and unexperienced physician, a favorable turn can be safely predicted, 
if the disease does not include meningitis. This can usually be done 
with a certainty. Inflammatory meningitis is, on the whole, a rare 
disease, which occurs only exceptionally in previously healthy chil- 
dren without precedent injury to the head, or diseases of the crania 



HYPERAEMIA. 109 

bone. Tuberculous meningitis, a more frequent disease, often escapes 
observation till the children have convulsions, but if we inquire care- 
fully we shall find that the attack has been preceded by long illness, and 
by other symptoms that we have overlooked or at least undervalued. 
If the child has been well the day before the attack, execept some 
signs of cerebral hyperaemia; if it has had no injury of the head, etc., 
you may be pretty cestain that it will be better, if not quite well, 
the next day. The attack is usually followed by deep sleep, from 
which the child awakes fatigued, but otherwise free from threatening 
symptoms. 

In some forms of hyperaemia the mental symptoms predominate to 
such a degree that the disease is often mistaken and,to the great injury 
of the patient, it is sometimes considered as an attack of melancholia ; 
at other times as mania. In the former case, after a few days of head- 
ache, disturbance of sensibility, and sleeplessness, the patients are 
seized with an undefined feeling of anxiety and disquiet. They can- 
not stay long in one place, go about restlessly are worried and are 
conscience stricken about slight oversights. There is also delirium, 
which has the same character as the above described frame of mind, 
and results from the attempt to explain it. 

At first the patient struggles against this delirium, which they oc- 
casionally recognize as such, and which they fear, as they think they 
are out of their mind, but they soon weary of the struggle and give 
it up. In such cases the sleeplessness is almost absolute. Opium, 
given by ignorant physicians, has no effect, and is dangerous to the 
patient. A short, restless sleep follows, however, the administration 
of opium, from which the patient awakes with all the symptoms in- 
creased. In this form of hyperaemia of the brain, which develops 
chiefly as a result of excessive mental labor; there is usually frequent 
pulse and other symptoms of fever, but in these very cases a greater 
amount of blood in the face does not correspond to the still greater 
amount in the brain. The patients are not high colored, but are 
often even pale. From the fever and sieeplessness they rapidly lose 
their strength, emaciate, and if not properly attended to, are in dan- 
ger of dying from this disease. Finally the excitement gives way to 
apathy, the insomnia to deep sleep, from which the patient cannot be 
aroused, and in which they die. 

In other persons, where the disturbance of the mind is an excess, 
it appears in maniacal attacks with corresponding delirium. This 



110 TREATMENT. 

form is especially seen after a long continued excessive use of spiritu- 
ous liquors; in that class of topers who for a year or so will use very 
little hquor, but when they have begun to drink, do not know when to 
stop, This cannot be mistaken for an attack of delirium tremens. 
The patients are sleepless, run about, fight and bite if they are held, 
destroy everything that comes in their way, cry, laugh or sing. There 
is also delirium of varying character ; usually the patients consider 
themselves as injured and betrayed and rage against their enemies 
and persecutors. 

The continued muscular exersion throws them into a perspiration, 
the heart beat and pulse are accelerated and stronger, the face is 
usually reddened. This form is also very dangerous if it be mistaken 
and improperly treated, for then an apoplectic attack, a true apoplexy, 
or an excessive rush of blood to the lungs, causes death. 

Treatment general. Keep the patient as quiet as possible and let him 
sit in an easy chair, apply chipped ice to his head by means of a blad- 
der or rubber bag; if you cannot procure ice, use moistened towels in 
very cold water, changing about every two minutes. If the patient 
has not had a passage for 6 hours previous to the attack give of pill 
cathartic comp., bottle No. 17, 2 pills, or if the stool has been sup- 
pressed for a longer time than just mentioned, give him a rectal in- 
jection of seven parts luke warm water and one part of pure vinegar. 

In cases af children give them injection only and a dose of castor 
oil. 

If the hyperaemia of the brain is caused by excessive use of alcoholic 
drink, add to above a foot bath of warm water, in which you put a 
good handful of each salt and wood ashes. 

In hyperaemia of the brain resulting from high living and no ex- 
ercise, it is very important in addition to the treatment prescribed to 
regulate the mode of life by avoiding prolonged, luxurious meals, with 
all the side dishes and strong wine and liquors, as well as coffee and 
chocolate, but induce them instead to eat a little oi plain food, drink 
water instead of wine, liquor, coffee or chocolate and walk a great 
deal. 

Persons subject to this disagreeable trouble, should lead a quiet 
life, arise early and go to bed at reasonable hours. Eat sparingly of 
rich food, avoid al] sorts of liquor, wine, beer, cider, coffee and choco- 
late. Leave off smoking and chewing and do not indulge in sexual 
excess. They should bathe themselves, if possible, every day in cold 



ANAEMIA. Ill 

water, or at least use the spong freely every morning all ever the 
body, especially on the head and in the heart regions. If the sufferers 
are mental workers, they should leave off work as soon as their brain 
feels tired and take a rest. 

The main points to be observed in hyperaemia of the brain, is that 
the flow of arterial blood to the brain has to be slackened and the flow 
of venous blood from the same is facilitated, and which will be accom- 
plished by the treatment prescribed. 

Anaemia of the brain is a morbid condition, in which the blood is 
deficient, either in quality or in quantity. 

The causes of Anaemia of the brain are those that diminish the 
blood in the organ, by abstraction, such as external bleeding, or 
hemorrhages, considerable sweating, ulcerations of ugly nature, and 
tedious, particularly feverish diseases. This form of disease is parti- 
cularly common in children, who have suffered from continued 
diarrhea. Typical examples are not infrequently seen as a result of 
extensive hepatization in weak persons with pneumonia. Protracted 
fevers also consume the flesh and blood of the patient and as one 
symptom of it, anaemia of the brain. In all of these diseases, blood 
and fluids of the body are lost or used up too rapidly; on the other 
hand, the amount of blood may be diminished by its formation being 
limited from insufficient supply of nourishment. Thus in persons* 
who have died of starvation, the most marked symptoms of anaemia 
of the have been observed before death. 

The affection also results from the overloading cf other organs with 
blood, so that the brain does not get its share. 

Cases where, from mental excitement, without of the heart's action, 
there is paleness of the cheeks and even loss of consciousness and 
other symptoms of insufficient supply of blood to the brain, seem to 
indicate that anaemia of the brain may also be caused by abnormal 
innervation or spasmodic contraction of the arteries. 

Anaemia of the brain is the necessary result of diminution of the 
space in the skull, caused by tumors of the brain, fractures of the 
skull, or any eneroachment on the cranial cavity. 

Since it is not merely the presence of blood in the vessels of the 
brain, but the supply of the oxygenated arterial blood that is indispens- 
able for the normal functions of the organ, it is evident that, even 
where the absolute amount of blood in the brain is not diminished, 
but where its circulation and distribution are changed so that only a 



112 ANAEMIA. 

small amount of blood enters through the arteries, and but little 
escapes through the veins, the same symptoms must arise as in true 
anaemia. 

The symptoms of anaemia of the brain, that comes on suddenly, 
and quickly attains a high grade, differ from those due to one which 
comes on slowly and is less severe. In the former case the patient 
becomes dizzy; everything appears dark before them; they become 
insensible to impressions and incapable of movement; their respiration 
becomes slow and they lose consciousness; they sink to the ground, 
usually with spasms. In most cases the patients come out of this 
fainting fit in a short time; in other cases, which is usually termed 
nervous apoplexy, consciousness does not return, the swoon ends in 
death. 

In anaemia of the brain, that comes on slowly, just as in hyperaemia, 
at first there are usually symptoms of irritation, subsequently those of 
paralysis. 

Occasionally the symptoms consist chiefly or exclusively in sensibility. 
The patient complans of severe head ache, either in the forehead or in 
the hind part, they are sensitive to light and sound, have flashes 
before the eyes, noises in the ears, dizziness, etc. These symptoms 
occur mostly frequently after severe bleeding from the womb, other 
than at the menstrual period, or other than extensive losses of blood. 

In other cases or anaemia of the brain, specially in children, the 
motor disturbances are more prominent and may be divided into two 
stages, i.e. irritation and torpor. In the first stage the children are 
very restless and capricious, constantly toss about in bed; readily 
frightened, they cry out in their sleep, gnash their teeth; the face is 
usually flushed, the pulse frequent- and the temperature elevated. 
There is almost always slight twitching of some limb, and often 
general convulsions. In the second stage the children collapse, become 
entirely indifferent to their surrounding, and their attention cannot be 
drawn to any object; the eyelids are half closed, the pupils insensible 
to light, respiration becomes irregular and rattling; finally death 
occurs with symptons of lethargy. 

Also, in anaemia of the brain, morbid symptoms in the mental 
functions preponderate; there are sleeplessness, great excitement^ 
delirium, etc, In some cases this increases to paroxysms of frenzy 
and decided maniacal attacks, The latter are seen in persons who 
have had no food or drink for a long time, but they are also not un- 



APOPLEXY. 113 

frequently seen in weak, bloodless patients, if their anaemia has 
been greatly increased by exhausting diseases and abstraction of blood. 
Treatment. If the anaemia of the brain be one symptom of general 
impoverishment of the blood, the patient must abstain from all physi- 
cal and mental labor and partake of an abundance of very nourishing 
food, eliminating those, which he knows from experience, do not agree 
with him. The patient should lie down as much as possible and if 
tke weather permits be in the open air. Let patient take one or two 
of the following pills, after meals, except supper. Blauds Feruginous 
Pills. Bottle No. 18. 

In profound and continued faintness, convulsions, ete., lay the 
patient flat on his back, remove all clothing, especially corsets, and 
give the patient whisky mixed with half milk, in teaspoonful doses. 
If the patient is unable to take this medicine, take of Hoffman's ano- 
dyne, bottle No. 25, 6 to 8 drops on a piece of cut loaf sugar and 
allow it to dissolve in patient's mouth. If too weak to take it in this 
form, dissolve some sugar in water, adding to it the anodyne and let 
patient swallow. Children suffering from this disease should be giv- 
en strong beef or mutton broth, raw scraped beef, as described, and an 
extremely nourishing diet generally, but no medicines. Very many 
patients and convalescents die, solely because they did not maintain a 
horizontal position. They must lie to relieve the heart and not force 
this organ to do work which it is not capable to perform, owing to its 
weakened condition. If we permit exhausted patients to rise to stool, 
or to leave the bed too soon, the feet are readily overloaded with blood, 
the heart receives too little; consequently a sufficient supply does not 
go to the brain ; the patient swoons, and not infrequently does not 
awaken from the fainting fit. In such cases give at once of the 
Hoffman's anodyne, Bottle No. 25, as prescribed. To condense the 
form of treatment we will enumerate the main points: 

Laying posture in bed, with little raising under head 

Strong nourishing food. 

Plenty of fresh pure air. 

No bodily exercise. 

And taking for some time of the Blaud's Feruginous Pills, 
Bottle No. 18. 
Hemorrhages in the Brain or Apoplexy. This term means the sud- 
den occurrence of complete functional activity, as caused by rupture of 
the bloodvessels and escape of their contents among the nervous mat- 
ter. It almost always occurs from the smaller arteries or the capil- 



114 SYMPTOMS. 

laries of the brain and are caused by structural disease of these vesssls, 
by the diseased condition of the brain surrounding these vessels and 
by increased pressure of the blood against the walls of the vessels. 
The bleeding usually occurs when several of these factors act together. 
The increased pressure of the blood on the walls of the vessels, by 
which the latter are ruptured, may depend on any of the causes, which 
you find indicated under hyperaernia of the brain. The frequent ocr 
currence of apoplexy during long and luxurious meals tends to show 
that the hyperaernia of the brain induced by temporary and excessive 
fulness is one of the most dangerous forms. Apoplexies occur at all 
times of the year; occasionally without any known cause. Advanced 
age furnishes the largest number of cases, still it has happened to 
children. Men are oftener attacked than women. There is such 
thing as an apoplectic consitiution, indicated by a short neck and 
broad shoulders. 

Symptoms. Sometimes apoplexy occurs unexpectedly in persons, 
w T ho have previously felt quite well, in other cases it is preceded by 
symptoms that excite in the physician and even in the laity, the ap- 
prehension that the patient is threatened with this disease. The 
patient complains of headache, or of heaviness and fulness of the head, 
of noise in ears, flashes before the eyes and attacks of dizziness; they 
sleep badly, are excited and irritable. There are also symptoms of 
occasional temporary feelings of formication and numbness in certain 
limbs, momentary loss of memory for some words and figures, or 
temporary paralysis confined to certain groups of muscles. There is 
no doubt, however, that frequent attacks of hyperaernia and anaemia 
weaken the bloodvessels in the brain and prepare that organ for 
apoplexy to destroy its functions entirely. 

The stroke of apoplexy rarely develops gradually. In most cases it 
comes on suddenly and the patient falls to the earth, often with a 
cry, as if knocked down. During the attack consciousness is entirely 
lost as well as the power of feeling and moving. Eespiration usually 
continues, but the inspirations follow at long intervals and are usually 
loud. There is often vomiting at the commencement of the attack; 
the pulse is very weak and the pupils contracted. 

Treatments Follow the same course as laid down in hyperaernia, 
and send for a good physician at once, there may be symptoms to his 
<eye, which may lead to save the patient's life. 

If the patient has one attack of apoplexy, he must be particularly 



INFLAMMATION OF THE BRAIN. 115' 

careful to avoid all causes by which the blood vessels in the brain 
may be overfilled and distended. He must especially avoid long, 
luxurious meals and must keep his bowels regular. He must abstain 
from wine, beer, ale, whisky or any other kind of aleoholic or malt 
liquors, also his coffea, if he takes any, must be very weak. Light 
exercise in open air will be beneficial. In bed his head must rest 
rather high. 

Cerebro, spinal meningitis, is a dangerous febrile disease, characterized 
by the inflammation of the membranes of the brain and spinal cord, 
giving rise to severe headache, tenderness of the back of the neck, and 
paralysis of the eye muscles. It is sometimes marked by skin erupt- 
ions, when it is called spotted fever. The disease is not contagious. 

Treatment. This being a very complicated disease, and is frequently 
caused by bad diet, malaria, cold, repression of the secretions, change- 
able weather, etc, It requires the most careful treatment by a trained 
physician, as so many things have to be observed and which must be 
counteracted, when they appear to the trained eye. The disease is 
very malignant and seldom allows a victim to escape. 

Before you can get medical aid, see to it, that the bowels are kept 
open by injections of lukewarm water, keep the body warm, immerse 
the body in a hot bath containing about a quart of salt, which brings 
the blood to the surface. The doctor will give other aid to help the 
sufferer, if within his power. 

Inflammation of the brain. In this disease, as in the inflammation 
of other organs, containing little connective tissue, very important 
changes take place in the nerve cells. They swell from absorption of 
nutrient fluid and subsequently break down. Afterwards pus cells are 
formed, also abscesses, the latter of which sometimes become capsul- 
ated. Inflammation of the brain is a rare disease and is not induced 
by causes which usually excite inflammation in other organs. 

The causes which usually bring forth this ailment is concussion, 
fracture of the skull, inflammation of the surrounding parts of the 
brain, especially that of the petrous or ear bone; irflammation of the 
ear can also lead to it. The disease never attacks the entire brain; it 
is always confined to certain points. The size of these points varies 
from that of a bean to that of a fist and even larger. The disease 
may be located in the small or large brain and is most frequently in 
the grey substance and very near the surface. 

symptoms are similar to those of attacks of apoplexy, irritation of 



116 CONSUMPTION OF THE SPINAL CORD. 

the entire brain, great slowness of pulse, increased bodily tempera- 
ture, headache, dizziness, sleeplessness, restlessness, exciting dreams, 
mild delirium, great sensitiveness to slight irritation of the organs of 
special sense and great weakness. The duration of the disease varies ; 
some cases terminate in death after a few days, while others linger 
long periods. Recovery is very rare. Even in the most favorable 
cases and where a partial cure has been affected, the functions of the 
brain remain impaired for the rest of life. 

Treatment. It cannot be very successful from the simple fact that 
the disease is not generally recognized until it has induced irreparable 
destruction of the brain. In order that you will not reproach your- 
self, it is well to call in the family physician, but he cannot do much 
more than to order cold compresses to the head. The patient 
must of course observe a proper diet and must be guarded from rushes 
of blood to the brain. 

Consumption of the spinal cord or locomotor ataxy. The causes of this 
disease are: 

Heridity, as from syphilitic parents. 

Veneral excess. 

Catching cold and bodily fatigue. 

After marching or other bodily exertions and then lie down on 
moist ground. 

Suppressed perspiration of feet. 

Syphilis. 

The disease is a degeneration of the grey parts of the spinal cord 
and in the latter stages shortening of the same. 

Symptoms. In many patients the characteristic disturbances of 
co-operation and the decrease of skin and muscular sensibility are 
preceded for a long time, even for years, by attacks of severe tearing 
pain in the lower half of the trunk, and in the lower extremities ; 
these are generally rheumatic. In other patients, on the contrary, 
the first complaints are that the lower extremities become fatigued 
very easily and very soon. Persons accustomed to walking notice that 
they tire sooner and more easily than formerly. These symptoms 
which, are not usually very suspicious, either to the patient or 
physician, may precede the decided symptoms of consumption of the 
spinal cord for a long time. The attacks of pain are unmistakably 
neuralgic and depend on the morbidly increased excitability of the 



SYMPTOMS. 117 

nerve roots. The tearing pain and tendency to fatigue in the lower 
extremities are not recognized to be serious and threatening until they 
are accompanied by other disturbances of sensibility, as, for instance, 
the feeling as if ants or other insects were crawling over the body; a 
feeing of numbness, and the sensation of a tight belt around 
the abdomen. Gradually the gait becomes uncertain and awkward; 
at first this is only so in the dark, so that the patient prefers remain- 
ing at home in the evening; afterward it is the same in the daytime. 
The feet are lifted too high, and thrown forward and outward, and 
brought down heavily on the floor. If the patient closes his eyes 
while standing erect he begins to totter, and, unless supported, falls 
to the ground. 

In many cases the foregoing symptoms are accompanied by disturb- 
ances of the excretion of the urine. Most patients are obliged to at- 
tend to the call to urinate as quickly as possible, as they can only 
stand it a few moments and hence it is to be recommended, that they 
buy urinals, which they wear in their trousers during the day. These 
symptoms arise because the patient does not perceive the fulness of 
his bladder, and the desire to urinate does not occur, until a few drops 
are pressed out of the bladder into the urethra. After a time walking 
becomes impossible, even with the aid of a stick or crutches, although 
when the body is fixed, the patient can generally make uncomplicated 
movements of the extremities with nearly normal force. The same 
uncertainty and awkwardness come on in the upper extremities, but 
later than in the lower. Then, when eating or drinking, the patient 
shake out the contents of the spoon or glass, they cannot longer dress 
without aid, especially the buttons trouble them ; finally they cannot 
write, knit, or do any other work. The involuntary discharge of 
urine, now often attains such a grade that the patient wets the bed. 
In consequence of this, a constant moisture of the parts be added to 
the patient indistinct perceptions of the irregularities of the bed and 
liis helplessness in changing position, bed-sores will soon aggravate 
this terrible disease. 

The course of the disease is always tedious, many patients drag on 
for years in a miserable state, the objects of pity. Occasionally the 
disease remains stationary; in other cases it appears to improve 
temporarily. Perfect cures are certainly very rare. 

Nutrition is frequently not impaired till late ; the lower extremities, 
the buttocks, and muscles of the back emaciate first, so that the bones 



118 SPASMS. 

of the spine project. It is not till towards the end of the disease that 
the emaciation extends to the rest of the body. Death generally 
results at last from the increase of the bed sores, from pulmonary con- 
sumption or from other diseases. 

It is asserted that at the commencement of the disease, sexual 
desire is usually increased but the energy and duration of the erections 
lessened, as well as that, in the latter stages, the cohabiting power is 
entirely lost. 

Treatment. Some hope may be entertained, when the cause of this 
disease is of a syphilitic origin. In such cases an an ti- syphilitic 
treatment should be instituted, and generally will bring good results. 

The more probable it is that, that the disease has resulted from 
taking cold, the more acute its occurrence, the more severe the pain in 
the lower extremities, which preceded the symptoms of disturbances 
of co-ordination and diminished sensibility, the more probable is it, 
that the disease is of inflammatory or congestive origin and the stronger 
to begin the treatment with blistering the skin along the spine, which, 
however, should be left to a physician. The best treatment, however, 
is when the disease is detected in time, to envelope the patient in a 
moist sheet and to allow him to sweat in it for quite a time, say 30 to 
45 minutes, and after rest from it and a good rubbing with a coarse 
towel, a luke warm bath should be given and the patient remain in it 
for about 3 to 4 minutes. Pain will easily be subdued by the adminis- 
tration of one dose of Phenacetine Bayer 2 gr., Bottle No. 23, every 3 
hours. The patient needs quiet, rest, good, pure air, close attention 
and strong nourishing food. 

Spasms are involuntary and unnatural contractions of one or more 
muscles or muscular fibres caused by the morbid irritability involving 
the twigs of the nerves, which go to the muscles. Among these 
diseases belongs the 

Mimic spasm of the face. In almost all cases the disease occurs in one 
side of the face, and the symptoms and course are about as follows: 
Grimaces occur either intermittant or constant, and chiefly consist in the 
elevation and depression of the frontal muscle, corrigation of the eye. 
brows, blinking and closing and closure of the eyelids, twitching of the 
nose, and drawing up or down the corners of the mouth. These at- 
tacks set in suddenly and as suddenly subside, to recur, with 
equal suddenness, at short intervals. The muscles feel hard and tense, 
and so impede motion that the one eye cannot be as completely closed 



PEN PALSY. 119 

as the other. The patient is unable to prevent or to control thesa 
motions at will. In the beginning of the disease the affected side of 
the face is somewhat painful. The course of the disease is usually 
chronic and of uncertain duration and often remains during life, if not 
nipped in the beginning. The course of these convulsions are mainly 
from suppressed mental emotion and also from the irritative instinct. 
Often it is the reaction, arising from remote organs, as the womb in 
hysteria. 

Treatment. As soon as noticed the patient should bathe the face 
every 2 hours in cold water, in which a small piece of camphor, 
Bottle No. 8, has dissolved. Almost any case will succumb to this 
treatment when applied in the beginning. 

Scricejiers spasm or -pen palsy, also called writer's cramp, is a morbid 
excitement of the motor fibres of the nerves which supply the muscles 
of the fingers and which renders further writing nearly impossible, 
by inducing spasmodic contraction of the finger muscles. It is seldom 
that women are afflicted with these spasms, but men have it often. It 
occurs mostly between the ages cf 30 and 50 years, that is, during the 
time of life when occupation is most intense. Professional penman, 
clerks, teachers and merchants are most subject to the affliction. 
Narrow coat sleeves, which compress the muscles of the arm during 
writing, an inconvenient attitude, but, above all, the use of hard steel 
pens seem to favor the development of the affliction. Why the disease 
should develop under these causes is unknown. 

Symptoms. The usually precursory signs of wrirer's palsy are a feeling 
of slight fatigue of the hand, and a sense of insecurity, as if the writer 
must grasp his pen more firmly. Sometimes the affliction does not 
advance beyond this stage. When the disease is fully developed, the 
muscles become convulsed during writing. During these spasms the 
pen is rapidly twitched up and down, but instead of regular distinct 
letters, it forms grotesque, interrupted scribbling. The harder the 
patient tries to continue his writing, so much the stronger 
the spasm. It is usually painless, although sometimes it is attended 
by a feeling of tension in the arm. The moment the patient ceases 
to write, the cramps are gone, and he can execute all other move- 
ments undisturbed. Writer's spasm is a very obstinate and tedious 
disorder. Kecovery is very rare and its uniform persistence is hardly 
ever broken even by a temporary improvement of the symptoms. 
Some patients who are ready for any sacrifice in order to be rid of 
this burdensome disease, and from their anxiety for the means of 



120 TREATMENT. 

subsistence, learn to write with the left hand. Unfortunately, how- 
euer, sometimes in such cases, the left hand is also attacked by the 
disease. 

Treatment. While the majority of remedies have proved to be of no 
avail, the following can be counted on to give lasting relief: Leave 
off writing for a weak or two, and in case you have to write make 
yourself a pen holder of cane stem, similar as are used for corn cob 
pipes, fasten a broad pointed pen in same without metal surrounding 
the tip point, and fill the cavity of the stem, which projects over the 
back of the hand, with molten lead; this will compel you to tighten 
the grip, but until relieved, do not use this pen more than is urgently 
necessary. Then go every day, or as often as you possibly can, to 
your butcher when he kills animals and stick the afflicted hand into 
the intestines as they are drawn from the slaughtered animal, keeping 
it in this animal poultice ten or fifteen m in utes. Besides this hold 
your hand under pump or hydrant and allow cold water to run on 
hand for 5 to 10 minutes at a time, repeating as often as five or six 
times daily. This will effectively cure any case of scrivener's spasms 
if not of too long standing. If the case is very severe, one 
quiniae sulph. 2 gr. pill, bottle No. 16, should be taken every morning 
after having had a stool. 

Cramps in the muscles of the extremities have somewhat the appearance 
of rheumatic affections, but it is of a different origin, and is to the 
muscles what the rush of blood is to the brain, and might, therefore, 
be termed hyperaemia of the muscles. If taken care of in the begin- 
ning nothing is to be feared, but if allowed to run along, it may be 
the cause of very troublesome diseases, inasmuch as it has a very 
pernacious effect upcn the assimilation and nutrition of the body and 
can cause great functional disturbances, such as typhoid, intermittent 
fever, Bright' s disease and diphtheria. 

The muscular cramps which arise during pregnancy, during labor 
and after it, also belong to this character. 

Symptoms. Sometimes the disease is preceded by a feeling of illness, 
languor and depression of several day's duration. The actual com- 
mencement of the disease is marked by pains, which apparently shoot 
along the lines of the nerves, and involving sometimes singly, but 
oftner the upper and lower extremities. Sometimes the hands or 
forearms and sometimes the legs are afflicted. 

In addition to this, there is a sense of formication and of stiffness 



PAEALYSIS. 121 

and sluggishness in the suffering parts. These symptoms having 
lasted for a variable period of time, cramps in the calves of the legs 
and other muscles, set in, which soon are converted into continual 
contractions. If you are unacquainted with this malady, and see a 
child thus affected for the first time, you will be deeply impressed 
by the aspect of the rigid immovable limbs, the extended knees, the 
heels drawn up, the thumbs forced into the palms of the hands and 
ascribed to some serious trouble. The attempt to extend the upper 
extremity or flex the lower is very painful to the patient. The con- 
tracted muscles are hard and prominent; the joints have a sort of 
swollen appearance ; the contracting extends to the muscles of the 
head and belly and to those of the face. The affection is usually free 
from fever. In some patients the contraction and the commencement 
of the contraction is accompanied by a sensation of oppression, and of 
rush of blood to the head. 

In the majority of instances the course of the disease is brief, the 
contractions ceasing after a lapse of a few days and free mobility be- 
comes re-established. The spasmodic attacks usually last for a few 
minutes. 

Treatment. The course of the disease, which nearly invariably ter- 
minates favorably, renders much medicine quite unnecessary. Friction 
of the afflicted parts with a stiff haired brush, usually relieves the 
spasm; a warm bath will do likewise. The pressure of a cold sadiron 
against the calf of leg, has a tendency to ameliorate the cramp. In 
severe cases, rub on afflicted parts spirits of camphor, bottle No. 
8, and give one dose phenaticine bayer, bottle No. 23. 

In grown persons, where stool is irregular, take one pill cathartic 
comp. bottle No. 17, at bed time. In children keep bowels open by 
means of injection of lukewarm water into rectum. 

Palsy or 'paralysis constitutes abolition of function, whether com- 
plete or partial, especially the loss of the power of voluntary motion, 
with or without that of sensation in any part of the body. 

It may occur from the separation of nerves from the brain or spinal 
marrow, partial or in whole. Catching cold, tumors pressing against 
nerve cords, and. certain shocks. Pressure and strain have also been 
the consequence. Eheumatism of long standing will also induce palsy. 
In fact, anything which has a tendency to enervate the body, such as 
a sedentary, luxurious and irregular life, or in persons who are en- 
gaged in intense studies or labor, under great distress or anxiety of 
mind, may be the cause of palsy. 



122 SYMPTOMS AND TREATMENT 

Symptoms. Palsy usually comes on with a sudden and immediate 
loss of the motion and sensibility of the parts; in exceptional cases it 
is preceded by numbness, coldness and paleness and slight convulsive 
twitches. "When the head is much affected, the eye and mouth are 
drawn on one side, the memory and judgment much impaired and the 
speech is indistinct. If the disease effects the extremities, and has 
been of long duration, it not only produces loss of motion and sensi- 
bility, but likewise a considerable wasting away of the parts affected. 
The attacks occur sometimes unexpected, but mostly they are preceded 
for days and even weeks by one or more of those symptoms, described 
as the formations of apoplexy, such as drowsiness, numbness, dim- 
ness of sight, failure of the powers of mind, and loss of memory. 

The paralytic stroke is usually sudden, but occasionally it approaches 
very slowly and the first affection in the latter case shows itself by the 
paralysation of either, a finger, hand, arm, the tongue or the eyelids. 

Treatment. Usually when a patient is affected with this malady, 
his bowels are constipated and they should be looked after at once, by 
giving a rectal injection of luke warm water. It is natural that the 
sufferer should be consigned to the bed and in a room where the fresh 
air is abundant. Eub the affected parts, when they are on the outside, 
with oil or mustard, Bottle No. 12, if that does not bring relief, ele- 
ctricity should be applied, which, of course should be done by a skilled 
physician. 

If the palsy is in the face and the same is caused by a blow or shock i 
cold compresses should be applied. When the disease has arisen from 
cold and is recent, the affected side of the face is to be covered with 
well wrung cold compresses, covered with oil-silk or india rubber 
cloth, and which are not to be changed until after the lapse of several 
hours. The face may also be wrapped in cotton wool and held over a 
pot of boiling water. At a later period stronger irritants must be used 
and oil of mustard, Bottle No. 12, applied to cotton flannel on hairy 
side and the other side covered with tallow is a good remedy of this 
character. The mustard application should not remain on affected 
parts for such a long period as to cause blisters. 

For palsy of the shoulder, when the application of oil of mustard 
fails to do its work, electricity should be applied. 

Progressive palsy is very abdurate to treatment and all one can do 
is to make the patient comfortable. 

St. Vitus s dance is attributable to a morbid irritability of the motor 



St. TITUS'S DANCE. 123 

nerves , while no derangement, or at least, no constant derangement 
of the intellectual functions can be detected. 

Symptoms. St. Vitus' s dance is charactered by movements of the 
voluntary muscles, which, however, are not excited by volition, but 
take place agamgt the will of the patient, his consciousness in the 
meantime being perfectly clear. These movements go on not only at 
times, when the patient does not intend to move, but also when he 
moves voluntarily. In the latter case, as the voluntaiy motion is 
complicated by the unvoluntary, the proposed action of the patient 
either is frustrated or earned out imperfectly or awkwardly. 

In most cases the disease begins very gradually and is not recognized 
for some time. It may be noticed that the sick child drops and breaks 
things a good deal; that it does not sit still; that it writes badly or 
makes more mistakes than usual in playing od the piano, and is ac- 
cordingly scolded or punished that it may be more careful and correct 
its awkwardness. The poor child often does not know what it has 
done, and in consequence of the unjust reproaches, becomes either 
sad and depressed, or else grows irritated and perverse. 

The restlessness of the muscles, meantime, becomes more and more 
apparent. The acts of awkwardness become more frequent and are 
grosser than ever. The child misses in reaching for its cup, stabs 
itself with the fork, or makes extraordinary grimaces. It is very 
unusual for this disease to develop suddenly, and from the outset to 
present the remarkable symptoms which characterize St. Vitus' s 
dance in its latter stages. 

In pronounced -St. Vitus dance the utmost variety of motion follow 
each other, in a manner so manifold and grotesque that the term 
•' insanity of the muscles " has been applied to the disease. In the 
face, the eyebrow, are alternately contracted and separated, the fore- 
head wrinkled and smoothed, the eyelids rapidly winked and now and 
then are fast closed for a moment. The mouth is successively pursed 
up, closed, then suddenly opened and shut, now spreading into a smile, 
now drawn down as if to weep, while the tongue is often and suddenly 
thrust forward. The head itself is turned forward, backward and 
sideways; the shoulders are raised or sunken. In fact every muscle 
of the body is in motion and beyond the control of the patient; they 
ara usually not capable to sit upon a chair, but slide off fixm it to the 
ground. The morbid restlessness grows all the more intense and 



124 SYMPTOMS AND TREATMENT. 

general, if the patients pay attention to it, especially if they know, 
that they are being watched. 

Nearly all the motions of the body, with the exception of those of 
deglutition and respiration, are seriously embarrassed by the restless- 
ness of the muscles. In eating the fork misses the lips ; in drinking 
the beverage is spilt, so that the patient often has to be fed. Even in 
slight cases all occupations requiring delicacy of manipulation becomes 
impossible, as, even in walking, the feet only touch the ground by a 
circutious route, and as the entire body is constantly making superflu- 
ous and irregular movements, there is something very remarkable and 
characteristic in the gait of the patient. 

The other functions and the general health suffer comparatively 
very little. It is easy to comprehend why the patient should be dis- 
spirited, sensitive and wilful, when we consider that for weeks he has 
not been master of his motions and that he has been constantly 
taunted about the mistakes he makes. Not unfrequently the grimaces 
of the patient are so at variance with his actual humor, or so unsuit- 
able to the subject of conversation, as to give him a foolish, imbecile 
look, although his mind is quite sound. When of long duration, how- 
ever, the accuracy of judgement seems really to be impaired, and other 
intellectual disorders arises. Sometimes, but not always, there is 
complaint made of headache and pain in the back. It is strange that 
the apparent exertions the muscles undergo, it causes no fatigue, the 
joints of the limbs, however, are sometimes swollen and painful from 
the constant strain and motion. St. Vitus' dance is usually not ac- 
companied by fever, although the pulse is generally somewhat quickened. 
The appetite, digestion, secretion and excretion do not present any 
constant peculiarity. When the disease has been of long duration, the 
nutrition of the patient suffers in consequence of the loss of rest, and 
he becomes blood poor and thin. 

The disease mrely terminates before the end of six or eight weeks, 
and it often continues for four or five months. There are rare cases 
even, which have been recorded, that the disease has become habitual 
and lasted throughout life. The rule of the ailment is, however, that 
recovery is the most usual termination of the complaint. It will only 
cause death when the disease becomes complicated with others. 

Treatment. In children, where the disease is most frequent, in fact in 
ninetycases out of a hundred, is caused by intestinal worms, give of San- 
tonin, Bottle 19, one granule and watch the stool if no worms are found in 



LOCK JAW. 125 

it repeat the dose four to five times. After the system has been 
cleansed of worms, St. Vitus' dance will usually disappear. In grown 
persons, where the cause is from rheumatism, a hot bath, prepared as 
follows: Take 8 ounces of iron filings and 2 pounds common salt, 
place it in an open vessel and fill it with vinegar, leave it there ti]l the 
iron is nearly or wholly dissolved, then take one-half of the mass and 
mix it in a hot bath (as hot as the patient can stand it, adding hot 
water as it cools) so that the patient is entirely immersed in same, and 
let him remain in it for at least one hour at a time. This bath should 
be given every other day. Then also give daily, morning and night, 
one Assafoetida pill, 2 grain, Bottle No. 20. On the day when the 
patient does not take a bath sponge his back with cold water, and 
rub dry with coarse towel. 

During convalescence the father, mother cr nurse should endeavor 
to teach the patient by a systematic and humane system of discipline, 
to resist the involuntary motions by the force of his will. 

Lock Jaw or Tetanno. is a derangement of the motor functions, and 
is usually induced by lacerated, punctured or gun shot wounds and 
wounds in which foreign bodies remain lodged. Injuries of this kind 
are more dangerous upon the feet and hands, in fact, the extremities, 
than other parts of the body. These wounds never give rise to lock 
jaw, however, except under certain conditions, of which sudden change 
of temperature is known to be one. Lock jaw may also be caused 
from the effect of cold, without any previous wound, as when a person 
has slept upon the moist earth, or v has been wet while his body is 
heated. An overdose of strychine will also cause lock jaw. It hap- 
pens oftener to men than women, and in stronger constitutions than 
in the weaker ones. The disease is more frequent in hot climates, 
than in colder countries. 

Symptoms. Lockjaw is characterized by continuous spasms, which 
principally involve the muscles of the trunk and the mouth. The 
malady is usually preceded by signs of fever, of no great severity, and 
pain and stiffness in the back of neck, which may readily be mistaken 
for a trifling fit of rheumatism. If such symptoms make their appear- 
ance after the receipt of a wound of a character as described, and if, 
at the same time, the aspect of the wound change, and should it be- 
come dry and painful, we may already fear great danger to the patient. 
When the disease has fairly set in, the head at first is almost always 
fixed and drawn backward, by rigid contractions of the muscles of the 



126 THE TREATMENT. 

neck. Spasms of the muscles of the mouth press the jaws firmly 
together, and, at the same time, swallowing is impeded or prevented 
by spasms of the pharynx. From the nape of the neck the disease 
extends over the muscles of the back. Thus the entire body is bent 
backward in the shape of a bow. The muscles of the abdomen 
and chest are also involved in the spasm. Hence the belly is tense, 
contracted and hard as a board and there is a sense of constriction at 
the pit of the stomach, which is very painful to the patient. The 
contracted muscles remain upon the stretch throughout the whole 
disease. The muscles are hard as stone and the seat of the most 
severe pain imaginable. The forehead is wrinkled, the brows knit, 
the eyes rigidly fixed, and sunken deep into their sockets. The angles 
of the mouth are drawn outward, and the lips are drawn apart, expos- 
ing the clinched teeth. The aspect of the patient in this condition 
awakens feelings of deep compassion mingled with horror. 

At the outset of the disease the paroxysms do not occur spontaneously 
but are provoked by the most trifling causes. A faint jolt of the head, 
the sound of shutting a door every movement, which a patient desires 
to make, the acts of chewing or swallowing or even the suggestion of 
the idea, suffices to bring on a new attack. The inability to swallow, 
and the spasmodic seizures induced by every effort to drink, create a 
certain resemblance between lockjaw and hydrophobia. At first the 
paroxysms are brief, but at the height of the disease, or even an 
hour before the remission sets in, consciousness and the intellect gen- 
erally remain unimpaired until the last in this frightful disease. The 
unhappy patient suffers from hunger and thirst which he is unable to 
relieve. As in all other violent muscular exertions, the skin is bedew- 
ed with sweat and the pulse is frequent and weak. The temperature 
is always high. The bowels are usually somewhat constipated, and 
sleep, though ardently longed for, is impossible. There are cases 
where the patient perishes only a few hours after the outbreak of the 
disease. The majority of patients are not relieved from their suffering 
so soon ; for three or four days the cramps and the frightful pain and 
dread of suffocation which accompanies them, continue to increase in 
duration and frequence until the sufferer expires. Recovery is ex- 
tremely rare. 

Treatment. Very few curative agents are known to the medical 
profession, which have proved to give favorable results. It is always 
to be recommended to call in the family physician, even if he cannot 
do much good, but it will always be a solace to the surroundings of 



EPILEPSY. 127 

the patient in case the disease terminates fatally, which it usually 
does. 

When the first symptoms appear, however, the following remedy 
shouid he ot once applied. Put the patient in a very warm bath and 
while in there protect him from all draughts and cold ; heat a half 
peek of pebble stones "red hot" and put them in an iron vessel; place 
over this vessel a bench or large cane bottomed chair, on which the 
patient sits or lies; then cover the patient with blankets and rubber 
sheet or waterproof, and empty into the vessel with the hot pebbles 
about a pint of water, adding more after it evaporates, and allow your 
patient to sit or lay in the vapor thus created. Of course his head 
must not be covered. Keep him in this vapor bath for 10 to 15 
minutes, rub him perfectly dry and put him to bed. It will usually 
relax the spasm. Other remedies will be furnished by the physician. 

Epilepsy or falling sickness is a chronic disease, characterized by con- 
vulsive attacks, accompanied by loss of consciousness, loss of sensa- 
tion and incapacity of voluntary motion. 

Symptoms, The outbreak is usually announced by a shrill cry, 
whereupon the patient looses all sense and falls to the ground, usually 
backward or sideways. He scarcely ever has time to see a convenient 
place, but falls regardless of place, often in a most perilous situation, 
striking, perhaps, against a hot stove, or sharp corner or falls down 
stairs. There are but few epileptics whose disease is of long standing, 
who do not carry with them the marks of more or less severe injury. 
The fall is usually followed at first by contractions, in whfch the body 
and extremities are extended, the head drawn backward or to the side, 
the mouth firmly closed, the eves wide open and rolled upwards or 
inward, the chest fixed and breathing temporarly ceased. After a 
few moments the jujular vein along the sides of the neck becomes 
distended and the face purple, and the whole body is thrown into con- 
vulsions. The countenance hitherto immovable is thrown into active 
agitation ; the angles of the mouth are drawn into all sorts of shapes ; 
the forehead and eyebrows twitch, the eyes open and shut, the jaws are 
forcibly pressed together, and are worked backward and forward so 
that the teeth grate audible. The teeth are not unfrequently broken 
off, the tongue bitten through, and even the lower jaw may be displac- 
ed. Upon the lips there appears a saliva, rendered frothy by the con- 
stant movement of the mouth and which, too, is often blood} 7- from 
wounds of the tongue or cheeks, The head is jerked forward and 



128 EPILEPSY. 

backward and from side to side; while the convulsive twitching of the 
muscles of the trunk, pitch the body in all directions. The fingers 
usually are flexed, the thumb being pressed into the palm of the 
hand, a sign, which most people erroneously believe to be character- 
istic of the disease. Throughout the whole fit the respiration is much 
embarrassed as is in all great muscular exertions, the beat of the 
heart is quickened, the pulse is small and irregular, while the skin is 
bathed in sweat. The bowels and bladder are often evacuated uncon- 
sciously, and it has also occurred that erection and seminal emissions 
have taken place. Throughout the entire fit consciousness is com- 
pletely extinguished that the patient is not aroused, nor does he be- 
tray any signs of pain, even though he may strike against a red hot 
stove, or fall into the fire so as to completely char a limb. After the 
fit has lasted for ten minutes, or, at the most, a quarter oi an hour, 
(which usually seems to the bystanders much longer) it subdues either 
suddenly, or the twitching gradually grows weaker" and weaker 
and finally ceases. In both cases it is followed by complete muscular 
relaxation. Yery often the fit terminates by a long sigh and now and 
then by vomiting and profuse evacuation of the bowels. 

It rarely happens that a severe epileptic fit is immediately followed 
by complete recovery; after the attack is over, generally, unless vio- 
lently aroused, the patient falls into a deep sleep with prolonged 
snoring respiration. If awakened from this he usually looks blankly 
or anxiously around him. He does not know what has happened, 
and can scarcely account for being in a strange place, or in bed, or 
wounded. His sole desire is to be allowed to sleep. Next morning, 
though still somewhat unwell and low spirited, and complaining of 
confusion about the head, he has recovered his faculties, and all traces 
of the attack vanish in the course of the day. 

While epileptics seldom recover fully from their disease, and are 
not usually long lived, yet they rarely die during an epileptic fit. 
Their death is much more frequently due to the progress of brain 
disease, which has given rise to the epilepsy, or the patient may die 
from the effects of injuries which he has received during a fit. 

Treatment. The best preventative means against epilepsy is doubt- 
less the avoidance of the intermarriage of families in whom this dis- 
ease is heriditary. Further^ an epileptic mother should never suckle 
her own child ; this duty should be delegated to a vigorous wet nurse 
or the nursing bottle. 

The following rales must be observed by epileptics. 



EPILEPSY. 129 

All exhausting and excessive mental occupations must be forbidden. 

Epileptic children must not sit 5 or 6 hours in a school room, but 
should spend most of their time in the open air and take cold baths 
under the proper supervision. 

Epileptics must not indulge in sexual intercourse; onanism, which 
is often the cause, must be stopped, intemperance in intoxicating 
drinks must also cease. Where these last mentioned vices exist they 
must be opposed with inexorable sternness. 

If the patient seems to suffer with a poverty of blood either in 
quantity or quality, let his diet be very nourishing and rich or in case 
of too much blood put the patient on a vegetable diet and let him 
drink large quantities of pure water and to exercise freely in open air, 
country preferable. 

In children epilepsy is often caused by intestinal worms, in such 
cases give one Santonin Granule, 1 gr.,, Bottle No. 19. Many cases 
cf epilepsy have been cared by an exclusive milk diet. 

In a fit where the patient protrudes tongue it should be put back 
into the mouth, and a piece of cork or very soft wood placed between 
his molar teeth. He should be laid on a couch or rug, fresh air freely 
admitted around him, his head slightly raised, and all clothing losened, 
which might possibly interfere with respiration. Throwing cold 
water on the patient's face should never be done as it does no possible 
good. The patient must not be bound or held during a fit, nor should 
his thumbs be forcibly unclinched. Many people think that the fit 
will soon subside if this is done. After the attack is over, those 
patients generally feel best, who have been allowed to struggle through 
it unmolested. The indications of the disease itself require, that the 
patient should be protected from the injuries which they are apt to 
inflict upon themselves during a fit. Whenever circumstances permit, 
an epileptic should not be permitted to go unwatched. This is the 
best and surest preventive. It is also a good plan to let a patient 
sleep in a bed with high sides, similar to a child's crib. After the fit 
the patient should be allowed to sleep undisturbed and as long as 
nature demands. Kegular outdoor exercise is very beneficial, but 
should not be indulged in, to such extent as to cause fatigue. 
Epileptics should be daily sponged with ice cold water and thoroughly 
rubbed dry after this ablution. The proprietors of this publication 
are in possession of a specific remedy against epilepsy, and will be 
pleased to communicate it to any sufferer from this dreadful disease. 



130 CONVULSIONS IN INFANTS. 

While they do not guarantee an invariable cure, they feel confident 
that epileptic sufferers will be largely benefited by the remedy, and 
the majority will only remember the past and not be afflicted, with 
the diseases after fully complying with the treatment prescribed. 

Convulsions in Infants, or Eclampsia Infantum. Is a sort of epilepsy, 
but differing, in the recurrence of the fit, instead of continuing for 
years, lasts for a few days, or hours only, at the end of which time 
the convulsions terminate either in recovery or death. It occurs in 
vigorous, full-blooded children, as well as in the puny, and in boys as 
often as in girls. One of the most frequent causes is, the practice of 
allowing the child to nurse immediately after the mother has been 
extremely angry. The child should not partake of such breast, until 
it has been properly drawn. 

Symptoms. For a few days the child is restless during sleep and 
sleeps with its eyes partly open, contorting the face and starting when 
touched. Even while awake, adifferencein in its manner is observable. 
The chilk is cross, does not seem to enjoy its play, cries a great deal, 
and often changes color. The character of these convulsions are 
itentical with epileptic fits, the head is thrown back, the extremities 
are extended, the eyes turned up, and the respiratory movements 
arrested, after which the convulsive motions commence. These 
spasms equal the epileptic convulsions in violence. The face is red- 
dened, frothy salivia appears upon the lips and the skin is bathed in 
sweat; the little belly is inflated from ant, which the child has swal- 
lowed ; the respiration is much embarrassed and the pulse is small 
and frequent. At the same time consciousness is entirely suspended, 
and with it all sensation. A fit of this kind usually lasts from a 
quarter to one-half hour and sometimes even longer. The fit usually 
terminates with a long drawn deep expiration, often, too, by a pro- 
fuse evacuation of the bowels. The child then falls into a deep sleep, 
and often, in fact, in most cases, on next day is as well as it ever was. 
Death may occur during these fits or also from exhaustion during the 
following sleep. It is a very dangerous disease among children dur- 
ing the first months of life, and a large proportion of those attacked, 
die, if not properly cared for. In older children the disease usually 
terminates in recovery. 

Treatment. If the previous health of the child has been good, and 
his appearance still be one of robustness and vigor during the fit, give 
the little sufferer a clyster of one part of pure cider vinegar and three 



131 HYSTERIA. 

parts of luke warm water and applying cold compresses to the head; 
the convulsions will soon subside. On the other hand, if the child be 
puny and enfeebled by long sickness, let him have a clyster of 4 drops 
Tincture of Valerian, Bottle No. 24, and 3 table spoonfulls of luke 
warm water. If the convulsions are very strong, moisten a piece of 
cotton flannel with oil of mustard, Bottle No. 12, and apply it to the 
calf of leg of the patient, but do not allow it to draw blisters. You 
may also place the little sufferer into a warm bath. Under no circum- 
stances give the child any paregoric, soothing syrup or other similar 
poisonous mixtures. 

Hysteria. The fact that hysteria is observed almost exclusively in 
females, and principally in females between the age of puberty and 
that of the extinction of the sexual functions, and that in a great 
number of cases hysteria is accompanied by a morbid condition of the 
sexual organs, have given rise to the supposition that hysteria is a 
disorder of the general nervous system originating in the nerve's of the 
organs of generation. All the womb diseases and those of the ovaries 
do not produce hysteria, it is more noticeable in ulcerations of the 
mouth of the womb and in the flexion or falling of the same. In rare 
cases hysteria is produced by irritation of the genitals arising from 
excessive sexual intercourse, or imperfectly effected coitus, from onan- 
ism or from simple sexual excitement. The last case, especially, is 
an extremely rare cause and it would be a sign of narrow mindedness 
and frivolity, as well as the most imperfect comprehension of the 
nature of women, to ascribe all cases of hysteria, whose source cannot 
be traced, to the structural change of the genitals, to an over excited 
sexual appetite, or to its unnatural gratification. In this connection, 
attention should be drawn to the ridiculous idea that all the hysterical 
widows or old maids, who are hysterical, without having diseases of 
their genital apparatus, suffer from suppressed sexual passion, or 
gratify it by an illegitimate manner. This belief is deep rooted in 
many, but anything more preposterous cannot well be imagined. 

The frequency in which hysteria occurs in childless women, in 
widows and in old maids of the upper classss of society, is attributable 
to mental rather than physical influences. The effect of strong mental 
impressions upon the nervous system at large it often quite evident 
even in perfectly healthy persons. 

Persons under the influence of great terror stand as if thunderstruck, 
unable to move from the spot; an angry man clutches his fist, bites 



132 HYSTERIA. 

his lips and moves restlessly to and fro without act of his will. Every 
day we have the opportunity of observing that mental emotion has an 
influence upon the excitability of the nerves; that it causes the cheeks 
to redden, or to grow pale, the muscles or skin to contract or to relax, 
the tears or saliva to flow. If all these various disturbances of innerv- 
ation can arise from transitory mental impressions, it is easy to 
imagine that permanent nervous derangement may develop under the 
influence of the permanent mental emotions, which beset a woman, 
who finds all the expectations and hopes of her life disappointed; who 
believes that she has failed in her vocation, and who, under the de- 
pression consequent upon such feelings, is unable to devote her 
thoughts into other channels. The state of mind which leads to 
hysteria depends not only upon external accidents, but much more 
upon the mental impressions made by the accidents upon the individ- 
ual. A fate which may befall one person without producing any 
apparent effect, may be the source of the deepest and most lasting 
depression in another. Hysteria is often seen in women, wedded to 
impotent men yet it originates quite frequently in the sombre feeling 
and miserable consciousness of a wasted life, which result, when 
social claims of married life are not duly respected, or when the senti- 
mental anticipations and fantastic ideals of a foohsh girl are not real- 
ized. 

Improper nourishment is often the cause of hysteria. 

The mode of life of a patient and her education have a most decided 
influence in this respect. The less a child is taught to control itself; 
the more it is allowed to indulge in immoderate grief over a broken 
toy; the more the rod is spared when it gives away to outbursts of 
excessive anger or passion, stamping its feet and throwing itself upon 
the floor, all on account of some disappointed expectation or the refusal 
of some request, so much more apt will it afterwards be to become 
hysterical. If we teach a child to be industrious to be conscientious 
and to control itself. If we prevent growing girls from doing some 
needle or crochet work all day long, or from occupying themselves in 
other wavs, which permit of their indulging in dreams and reveries; 
if we keep improper books, likely to give them stilted ideas out of 
their hands, we shall have done our best towards averting the danger of 
hysteria. 

Hysteria is a very rare plenomenon among men. Here, too, it us- 
ually proceeds from derangement of the sexual apparatus, although 



HYSTERIA. 133 

this is not always the case ; but in men, likewise, it is only in in- 
stances of decided congenital or hereditary tendancy to the disease 
that it can be excited by venereal excess, onanism, and the like. 

Symptoms. The most striking are the uneven and fluctuating state 
of the circulatien in the outside portion of the body. Most patients 
have cold hands and feet (constantly), while, without apparent cause, 
the natural color of the face gives place to a glowing redness, often 
accompanied by a burning sensation. The urine which is discharged 
in large quantities, contains but little of the solid, constituents of the 
urine, is of a watery appearance and hardly any odor. In the first 
place in the outset of the affection we are struck by the rapid fluctua- 
tions which takes place in the spirits of the patients, and by the 
sudden transitions from the most unbounded gayety to the prof oundest 
gloom. These symptoms are ascribable to the mental and physical 
sensibility of the body. As mental impressions produce an unusual 
influence upon the temper of the patient, so, too, suggestions which 
would produce no apparent effect upon the spirits of a healthy person, 
produce a sense of annoyance or of repugnance in an hysterical one, 
seldom however if the sensation is one of gratification and pleasure. 
While the affection is still recent it is almost always possible, by 
adroitly conducting the conversation, in the course of a few minutes, 
to make the patients laugh and weep alternately. The real jud im- 
maginary impressions which inspire the patient with a sense of dis- 
gust or displeasure are the predominant ones, so, her spirits gradually 
become more and more depressed. She is constantly sad, - unhappy, 
and in despair about her fate, even although she may be in possession 
of everything which can tend to make life enjoyable. This constant 
and apparently unreasonable lamentation and weeping, gradually tire 
out the sympathy of the friends of the patient. Her relatives become 
indifferent to her troubles, do not listen to her complainings, or allow 
it to be perceived that they are becoming tired of them. Unfortunately 
hysterical persons become subjects of ridicule to the inexperienced ob- 
server. It is to this absence of sympatny and to this gradual diminu- 
tion of interest, that we may most reasonably ascribe the tendency 
which develops in nearly all hysterical patients to exaggerate their 
complaints and to feign diseases, a tendency wbich, although really a 
sympton of the malady, does away with the last vestige of sympathy 
for their condition. The capacity of such a patient for inventing con- 
ditions calculated to excite notice or sympathy is something incredible, 
and is often very difficult to separate the truth from falsehood. It is 



134 HYPOCHONDRIA. 

a very common 3currence for a patient to declare that she cannot 
make water, and for her to submit to the passage of a tube into her 
bladder twice a day. It is equally common for her to remain in bed 
for months or years, asserting that she can not stand upright. It is 
easy to see what a treasure animal magnetism must be to a hysterical 
person, and with what alacrity they submit to the manipulations of 
the "magnetizers", and that having once "got into magnetic relation" 
with some other person, and thus become enabled to perform all man- 
ner of new tricks, they leave off their old ones, and thus are "cured of 
the most wonderful diseases by animal magnetism." It is only 
necessary for the right man to appear, in order to convert any decidedly 
hysterical female, to the opinion that she is all right. 

The power of reason usually remains unimpaired in hysteria. Like 
other people, they are able to connect one idea with another, and to 
form correct conclusions, although they are so preoccupied with a 
sense of their own sufferings as to be unwilling to think of other 
matters. 

At the menstrual period and immediately prior to it, the disease is 
almost always aggravated. Death from hysteria is one of the very 
rarest occurrences. 

Treatment. Cold water baths taken regularly every morning, exer- 
cise in open air, good plain nourishing food ; to abstain from all alco- 
holic or malt beverages are the principal rules which must be followed 
before looking towards relief. Then take every morning one pill of 
assafoedida, 2 grains, bottle No. 20, and should, in the beginning of 
the treatment, the fits be of a strong nature, give of tincture of valer- 
ian, bottle No. 24, 2 drops in a tablespoonful of cold water during the 
attack. 

Moral treatment is of the most utmost importance in all cases of 
hysteria, whatever the source of the disease may be, and you must 
endeavor to exercise the patient to oppose the impulse and try to have 
her overcome by will power the hysterical attack. In your persuasions be 
kind but firm and let your patients feel that they have your fullest 
sympathy, but that you will tolerate no nonsense. 

HypocJiondria is a disease of the mind, it being oppressed by a pain- 
ful impressions. The hypochondriac is always bothering himself by 
the idea that he is sick, or that he is going to be sick. The predis- 
position to hypochondria is very slight indeed during childhood and is 
far less in females than in males. It is greatest between the ages of 



HYPOCHONDRIA. 135 

twenty and forty. Its origin seems to proceed from debilitating influ- 
ence, from disappointment, failure of speculations and an ill selected 
career. 

It is very often induced by the companionship of a hypochondriac 
with persons having a predisposition. 

Symptoms. It develops very gradually, at first there is a sense of 
illness, which troubles and oppresses the patient, but which does not 
disturb his judgment. The mere profoundly the disease takes root, so 
much more does the patient endeavor to discover his indisposition. 
He scrutinizes his tongue, his stools, his urine; he counts his pulse 
and handles his abdomen. Every trifling irregularity which he per- 
ceives, the slightest irritation, the faintest coating of his tongue, a 
transient colic, an insignificant cough, are all of the utmost importance 
to his eyes ; not because he suffers more than any one else from such 
symptoms, but because they seem to afford him a clew to the nature 
of the grave and obscure imaginary disease. To-day he may dread an 
apoplexy, to-morrow he may think that he has an ulcer of the stomach, 
at other times he imagines that he has heart disease, or that he is 
consumptive, or some other grave malady. A hypochondriac always 
thinks the doctor makes light of his sufferings. 

In the worst form of the disease, the patient loses all interest for 
matters, which do not bear upon the state of his health. He becomes 
abstracted, forgetful, and negligent of his affairs, gives himself no 
further concern about his family, and often remains idle in bed for a 
long time. 

Treatment. It is useless to dispute with a hypochondriac and to try 
to convince him of the error of his ideas. The only way to cure the 
patient is to rid him of his morbid sensations, by effecting relief for 
the disease he complains of. The patient should be bathed every 
morning in cold water and attention should be paid that his bowels 
are kept open by administering every other day for one week, one Pill 
Comp. Cathar, Bottle No. 17, never allow the patient to overdose 
himself. Further the patient should be induced to take long walks 
in the woods or open country, always accompanied by some congenial 
friend, who will divert his mind. The sawing of wood, practice of 
gymnastics and almost any mechanical pursuit is good for the patient. 
Amusement such as the theatre or concert, produce some benefit, 
more, however, is effected by traveling, or the study of some agreeable 
object. Be it remembered that more good can be done to the patient 



136 MELANCHOLIA, ETC., ETC. 

by diverting his thoughts from his imaginary disease, chan by all the 
medicines in existence. 

i Melancholia, is also a disease of the mind, when the patient imagines 
all sorts of things ; such as believing himself an outcast and lost for- 
ever, that people talk about him, takes almost everything for an insult* 
is easily scared. Such patients are dangerous to themselves and 
others. Through suicide, murder and arson he endeavors to help 
himself. His mind is in the first stages of being unbalanced and the 
poor sufferer should be placed in an asylum, where a cure is usually 
effected sooner or later. 

Mania belongs to the same class of diseases as the foregoing and 
can best be portrayed by the first stages of intoxication. Its symptoms 
show themselves by taking great risks, unusual mental activity and 
hobbies for impracticable things. A patient suffering with mania, 
thinks quickly, but his thoughts do not become mature. He acts on 
first impulse without considering consequences, and often has such 
patient ruined his family by losing everything in wild schemes and 
speculations. Such sufferers, if they have the disposal of money at 
their command, should be placed under guardianship, till their condi- 
tion can be altered, and which is best done in an asylum. 

Insanity and Idiocy. Sufferers with these terrible ailments should 
not be allowed at large and be taken care of in the proper places of 
the state or of a private nature, and very often permanent cures are 
affected. To treat these diseases in the ordinary way is not alone a 
folly, but often becomes the cause of a crime when the patient is left 
unguarded. 

Dream?. Are usually signs of a bad digestion and illy ventilated 
sleeping apartments, and if you remedy the causes you will not be 
bothered with dreams and awake refreshed in the morning after an 
undisturbed night's rest. 

Somnambulism or sleep walking is a condition of the nervous system in 
which an individual, during sleep, performs actions appropriate to the 
walking state. 

Treatment. Light supper will, well ventilated rooms, no excitement, 
cold baths and nourishing food sparingly taken, in connection with 
watching the patient are the best preventives for this disease. If con- 
stipated, regulate the bowels by a fruit diet. When a somnabulist 
gets up at night and you notice him in his act, be careful and do not 



APHASIA. 137 

scare him, rather coax him gently back into his bed, and bathe his 
forehead with cold water. 

Aphasia is a condition of the mind, which prevents a patient partially 
or in the whole to express his thoughts. It is caused usually by a 
rush of blood to the brain and subsides generally when the blood has 
been absorbed. 

Treatment. Cold compresses to the head and be careful not to excite 
the patient, but endeavor to analyze the correct wishes of the patient 
and grant them, if within reason. 

Stottering is an ailment, induced by not having proper control over 
the respiratory organs. 

Treatment. Never look at a patient when speaking, and induce him 
to talk slow after he has formed his thoughts. In children "Patience ' ' 
is the best cure. When it is a nervous affection, give a nourishing 
diet. 

Monotony in Voice, is usually a residue of diseases such as typhoid 
fever, scarlet and diphtheria and about the only remedy is electricity, 
scientifically applied by a specialist. 

Alcoholism, acute and chronic, a disease so prevalent that it does not 
require any description. 

Treatment. In dangerous cases of intoxication put cold compresses 
to head and make the patient drink large quantities of luke warm 
water till vomiting follows. One hour after vomiting give five drops 
of Tincture of Valerian, Bottle No. 24, in wine glass full of water. 

The best remedy, however, is to abstain entirely from any intoxicat- 
ing beverage and a person, who has formed this resolution, should be 
aided by moral support in keeping it. 






Diseases 
Of the Organs of Digestion 



M 



THE MOUTH. 
BLISTEES AND CANGEES 

EE those little blisters, which form in all parts of the mouth, 
when the digestive organs are out of order, and contain a 
watery fluid. 

Treatment. Clean your mouth thoroughly with luke warm water. 
Dissolve borax, Bottle No. 3, about a thimble full in a glass of pure 
warm water, and fill your mouth with the solution, keeping it there as 
long as you can stand it, also gargle then spit out, never swallow. 
Take inwardly of Chorate of Potash, Bottle No 7, about as much as 
will lie on the point of a pen knife, dissolve it in a table spoonful of 
water and swallow. 

Toothache. The best remedy for this is to keep your teeth well 
cleansed, using nothing but pure water and the brush. Avoid all 
tooth powder, tooth paste and sundry articles. If your teeth are de- 
caying, let the dentist look after them. Never have a tooth pulled if 
it can be otherwise fixed up. 

If the toothache is of a neuralgic character use the remedies pre- 
scribed for that disease. 

If your teeth are decayed and show cavities have them filled, but 
in order to kill the pain, which you suffer, before you can see the 
dentist, saturate a bit of cotton in Carbolic acid, C. P. 10%, Bottle 
No. 5, and put same into cavity. 

Teething of children is nearly always accompanied by other troubles, 
such as fevers, restlessness, flow of saliva and swelling of the gums. 
The child should be kept quiet during this period, not be subjected to 
draughts and sudden changes of temperature, if possible its diet should 



SCUBYY. 139 

be nothing but the mother's milk. Mothers should not excite them- 
selves or fret, as that would cause pain to child. Keep the mouth of 
the baby clean and wipe it out carefully every day with a clean wet 
rag. Should you find any blisters, dissolve a pinch of borax, Bottle 
No. 3, in a glass of water and wipe the mouth with it, and cleanse it 
afterwards with "water. 

Inflammation of the Mouth can be of catarrhal, croupous and 
diphtheritic origin, and is usually only found in babies after they have 
some of their first teeth, which make quite visible impressions in the 
mucous membrane of the tongue and cavity of the mouth. The in- 
flammation often stretches over the whole cavity and shows swelling 
of considerable extent. The cry of the little sufferers is hoarse, their 
breath of a bad odor, and they cannot be induced to take the breast, 
and when driven by hunger to take it, usually let go under heart- 
rendering cries. Such babies should then be fed with a teaspoon. 
Their little mouths are dry and seem to be burning and swallowing 
seems to be laborious. 

Cropous inflammation can further be noticed by the fermation of a 
thin membrane, which, when in shreds, is pulled away, often leads to 
severe bleeding. 

Treatment. Keep the bowels of the little sufferer open by injection 
of luke warm water and wash the cavity of the mouth with Borax, 
Bottle No. 3, one-quarter teaspoonful to a tumbler of water, which 
should be of proper temperature. Apply this solution to a clean linen 
rag and apply about every 3 hours and your little one will be soon on 
the mend. 

Sore mouths of grown people should be treated likewise, by dissolv- 
ing ona teaspoonful of Borax, Bottle No. 3, in a tumbler of water, 
taking a mouthful every 30 minutes and keep it in mouth as long as 
possible and then spit it out. Never swallow this medicine. 

Scurvy of the mouth is most frequently caused by a diet consisting 
chiefly of salt meat and the absence in the articles of food, of potatoes 
and other vegetables. 

Symptoms. Chewing is very painful and often impossible, on ac- 
count of the swelling of the gums. The secretion of mucus and 
saliva in the mouth is greatly increased. Haemorrhages occur on at- 
tempting to chew, as well as from slight pressure on the gums. The 
decomposition of the contents of the mouth, which are mingled with 
blood, causes a very penetrating and disagreable odor. These sym- 



140 « MUMPS. 

ptoms, taken together with a feeling of great debility and lassitude, 
and particularly of a sense of excessive weight in the lower limbs, de- 
pression of spirit, a sad feeling and despondency confirms the diagnosis 
of a scorbutic affection of the mouth. 

Treatment. The patient should be put on an exclusive milk and 
vetable diet. Let him drink the juices of 3 lemons daily (in three 
doses) and take of white oak bark (next to tree) 6 ounces and boil in 
three pints of water, down to one quart strain, and use the decoction 
as a mouth wash. Very beneficial in scurvey of the mouth are the 
juices of mustard leaves or water-cresses. Take these herbs and 
mash them immediately after you bring them from the garden and 
press the juice from the pulp. Give hourly in teaspoonful doses. 

Mumps or Parotitis is an inflammation of the parotid glands. 

Symptoms. It is usually preceded by fever, accompanied by depres- 
sion, headache, loss of appetite, restless sleep, etc. After the fever 
has lasted two or three days, or in some cases simultaneously with its 
occurrence a swelling forms, which, beginning near the lobe of the 
ear, rapidly extenes over the cheek and to the neck. Usually only 
one side is at first affected. In the middle it is firmer and at the sur- 
face softer; the skin over it is pale or only slightly reddened. This 
swelling is accompanied by a feeling of tension and pressure, but no 
severe pain ; the motions of the head are impaired, the mouth can 
only be slightly opened arid chewing and swallowing are difficult. 
The annoyances are so slight in proportion to the disfigurement, 
which gives the name to the disease, that the patients excite more 
laughter than sympathy. The swelling almost always soon extends 
to the other side of the face. About the fifth or sixth day, occasion- 
sionally even earlier, rarely later, the fever ceases, and after eight or 
ten days the face appears natural. 

Treatment. As mumps always end in a cure if left to itself, we 
have only to protect the patient from injurious influences, and to reg- 
ulate the digestion and bowels, while the disease lasts. His diet 
should be a light one consisting of soups and gruel. The bowels 
should be kept open by fruit, or if the patient shows obstinacy in its 
influence, give him, if a grown person, in evening about 8 or 9 
o'clock, one pill, cathartic comp. vegetable, bottle No. 17. With 
children a dose of castor oil will suffice. Keep the patient in bed, 
cover the swelling with wadding and as long as the fever lasts do 
not allow him any meat or eggs, or anything hard to digest. If the 



SORE THROAT. 141 

swelling becomes hard and apparently forms suppuration, you had 
better call in a surgeon to make a small inscission to let the pus out. 
If the swelling be red and the patient winces when you press on it, 
apply cold compresses. In strong fluctuations warm poultices of corn 
meal are very beneficial. 

Salivation or abnormal flow of saliva The normal secretion of saliva 
during twenty-four hours in a healthy person of full growth is usually 
estimated at ten ounces, but varies even in health one or two ounces 
more or less. When any of this saliva fails to pass into the stomach 
with the food, or flows from the mouth, or is spit out or is swallowed 
by itself the saliva does not perform its function and that is disease. 

It is caused by irritation of the mucous membrane of the mouth, 
by strong substances, such as tobacco, liquor, etc., ond also by con- 
stipation. 

Symptoms. Pain in the mouth and swellings. Frequent collection 
of saliva to such extent that the patient is obliged to spit constansly. 
Thus the escaping fluid may reach four to seven pounds in twenty- 
four hours. 

The patients usually emaciate, as they take but little nourishment, 
and what they do take is badly assimilated, because the quantity of 
saliva swallowed interferes with digestion. 

Treatment, In case of children give them an injection of lukewarm 
water, until their stool is perfectly regular, and wash their mouth 
with a solution of borax in water, taking one-half teaspoonful from 
bottle No. 3, to ore glass of water; if they are large enough let them 
gargle with this solution and keep a spoonful of it in mouth as long 
as they can. For persons over 15 to 18 years of age give at bed 
time one pill cathartic comp., vegetable, bottle No. 17, and use mouth 
wash of borax solution. 

Sore throat. The predisposition for this disagreeable in- 
flammation varies much with the individual. If exposed to 
the slightest injurious influences, such as draught, some persons are 
immediately attacked with affections of this part, while others exposed 
to the same influences remain well. Among the causes inducing this 
disease are: Direct irritation, such as very hot substances, rough, 
ragged bones which stick in the fauces, spirituous liquors, catching 
cold. Syphilitic persons are nearly always troubled with it. 

Symptoms. In acute cases the patient has usually a fever, the secre- 
tions are diminished and the patieut complains of dryness in the 



142 PHARYNGITIS. 

throat. The back part of the mouth and especially the soft palate 
appears dark red and swollen. The uvula is thicker and longer and 
often rests on the root of the tongue. 

The disease almost always terminates in early recovery. 
Treatment. Take at bed time one pill cathartic comp., bottle No. 
17, and repeat if you are constipated next evening. Make a throat 
wash as follows : 

One glass lukewarm water. 
Ten drops carbolic acid, 10% c. p., bottle No. 5. 
One teaspoonful chlorate of potash, bottle No. 7, 
After the latter is dissolved, gargle with the solution every hour. 
Keep out of cold and draught and wash neck morning and night with 
cold water, rub thoroughly, dry and cover with flannel. 

Pharyngeal croup. It occurs from the same causes as the preceding 
disease, and can be recognized by white or greyish white spots on the 
reddened mucous membrane of the soft palate, tonsils and back part 
of fhe mouth. The disease occurs nearly exclusively in children and 
is often epidemic. 

Treatment. Keep the bowels open by injections of lukewarm water 
and use the mouth wash as prescribed for the preceding disease. 
Should those white spots form a membrane over the larynx, send for 
a surgeon to remove same instantly. 

Inflammation of the pharynx, or Pharyngitis, usually attacks the 
tonsils, which swell to the size of a walnut; their surface appears 
knotty, ddrk red and covered with croupous deposits. The inflamma- 
tion passes to suppuration, some spot usually becomes softer and 
more prominent, and finally the pus perforates the thinned walls of 
the abscess. 

Symptoms. The disease generally begins with a high fever, which 
may be preceded by a severe chill. The general condition of the 
patient is much affected, the pulse full and frequent, the temperature 
104 ° or over. In this case you have to deal with an inflammatory 
fever, such as accompanies pneumonia. "With the commencement of 
the fever, the patient complains of a feeling of tension and soreness 
in throat, and after, of piercing pain, extending towards the ear. It 
feels to them as if there was a foreign body in the back part of the 
mouth, hence they make constant attempt to swallow, although this 
motion increases their pain. The secretion of saliva is often enor- 



THE STOMACH. 143 

monsly increased; if the patient opens his mouth without spitting the 
saliva runs from the corners of the mouth. The tongue is thickly 
coated, the odor from the mouth very unpleasant, there is also the 
characteristic modification of the voice, its resource is changed, the 
speech has a peculiar nasal twang, from which the disease can often 
be detected. On examination of the mouth and pharynx, which is 
done with difficulty, you will find the tonsils swollen so as to touch 
each other. While the local symptoms are thus increased for three 
or four days, the fever grows higher and symptoms of hyperaemia of 
the brain oceur, the patient has severe headache, is sleepless, torment- 
ed by horrible dreams, or even becomes delirious. When the inflam- 
mation goes down, the local and general symptoms usually subside 
towards the end of a week and the patient usually recovers in a week 
or two. W T hen suppuration occurs and abscesses form, there is a cer- 
tain remisson after the symptoms have reached the highest point. 
The patients often preceive the opening of the abscess only by the 
sudden relief they experience, or the pus may be swallowed or over- 
looked; in other cases the opening of the abscess may be instantly 
recognized by the fetrid odor and the yellow substance thrown out. 
After the opening of the abscess convalescence is generally very rapid. 
Treatment. If detected in the beginning apply of powdered alum 
bottle No. 1, to the inflamed parts two or three times a day and rinse 
the mouth with a solution of alum, bottle No. 1, about as much as 
will lay on the point of a table knife, to a big glass full of barley 
water, which is made like oatmeal gruel, only thinner, and without 
spices or flavoring, heretofore described. In addition to above allow 
the patient small pieces of ice or ice cold water to take into his mouth, 
and cover the throat with cold compresses, which must be frequently 
changed. If suppuration occurs use warm poultices, either of corn 
meal or linseed meal around throat and wash out the mouth frequent- 
ly with lukewarm water, and open the abscess as early as possible 
with your finger nail. It must be understood that the patient keeps 
his bed, that the bowels are kept open, using injection of lukewarm 
water, if necessary, and that he only takes liquid food, avoiding all 
meats and fat, while the fever lasts. 

THE STOMACH. 

Overloading hapens often to indiscreet persons and to children, who 
have their diet watched and regulated too much and when they have 
a chance to eat to their hearts' content. 



144 CRAMPS IN STOMACH. 

Symptoms. Fullness and pressure in the regions of the stomach, 
flow of saliva and stupid feeling in head. Sour gases evaporate from 
stomache, heartburn and hickups are also consequences of this indis- 
cretion. 

As this trouble generally happens to otherwise healthy persons, it 
will regulate itself by fasting and giving the stomach a chance to 
work off its load in the natural channel. 

Pain in stomach happens often when digestion is interfered with,, 
such as overloading, or drinking cold water when you are hot. 

Treatment. Take a pinch of magnesia, bottle No. 11, in a teaspoon- 
ful of water ; if you have no relief in twenty minutes, take a very 
strong cup of coffee and take it as hot as you can without sugar, milk 
or cream. 

Cramps in stomach are heavy pains in the stomach region, and often 
so intense that the patient swoons, the saliva flows very freely and 
hickups ensue. The pain is often noticeable in the regions of the 
navel, chest and back. It occurs mostly in girls or women who have 
troubles with their monthly period. The duration of the trouble is 
seldom longer than two hours, and usually ends in throwing off a lot 
of gases and elimination of large qnantities of nearly water-white 
urine. Cramps in the stomach are very frequent in persons suffer- 
ing from anaemia, hysteria and hypochondria. 

Treatment. Give of extract of ginger, bottle No. 9, one teaspoonful 
for a grown person, in one-half cup of lukewarm water; also apply to 
the regions of the stomach the following : Take a piece of cotton 
flannel and cover tW side on which no fur is with tallow or lard and 
saturate the fur side with oil of mustard, bottle No. 12, and let it lay 
on stomach till skin beeomes red, but do not allow to blister. If the 
patient is constipated give injection of lukewarm water with ten drops 
tincture of valerian, bottle No. 24. Persons predisposed to this 
trouble should use warm clothing and keep their feet warm. Girls 
and women should keep flannel on their chest and not lace too tight. 
During their monthly periods they should lay down and not pass 
around too much. The diet should be easily digestible, eliminating 
entirely fats, sour and sweet dishes from the list. The meals should 
be sparingly at a time; better take food oftener when you feel the need 
of it, so that the stomach never becomes overfilled. The evening 
meal should be very light, tea and toast without butter is to be rec- 
ommended. Ladies having trouble of this kind should make it a rule 



CATARRH OF THE STOMACH. 145 

to avoid the following : Dancing, tight lacing, low cut dresses and 
mental excitement, hut practice "early to hed and early to rise, etc." 
Catarrh, of the stomach. During normal digestion changes occur in 
the mucous membrane of the stomach, which, if found in other 
mucous membranes, w T ould be called catarrh. The secretion of gastric 
juice is always accompanied by considerable rush of blood to the 
mucous membrane which is regularly followed by an abundant flow 
of mucus. This physiological process is accompanied by a slight 
general disturbance, the so-called digestive fever. Hence the defini- 
tion that is usually given for catarrh of mucous membranes generally, 
does not answer for gastric catarrh, and we can only speak of gastric 
catarrh when the physiological process increases beyond normal 
bounds. It will be readily understood that, as the act of digestion is 
repeated several times during the day, and our food is complicated, 
and sometimes of improper character, the process may readily become 
abnormal; hence, as may be easily conceived, acute catarrh of the 
stomach is one of the most frequent diseases. Under favorable cir- 
cumstances the disease is only of short duration. The predisposition 
to this affection varies with the individual, in some persons it is in- 
duced by exciting causes, which would have do effect on others. 

In many cases it is owing to the scanty secretion of gastric juices, 
which favors abnormal decomposition of the food placed in stomach. 
Fever patients usually suffer with gastric catairh, owing to the in- 
creased temperature, and the increased loss of water, and retarding 
the secretion. In such cases, if the patients do not bear in mind, and 
adapt their diet to the diminished secretion of the stomach, very dis- 
tressing catarrh of the stomach will result. A large portion of the 
gastric complicaticns in pneumonia and other inflammatory affections 
result from neglect of this simple dieticrule. 

Catarrh of the stomach is more readily induced by a slight excess 
in drinking, in persons unaccustomed to the use of liquor, than those 
w T ho take a moderate amount daily. Persons who have suffered once 
from this affection are very liable to do so again if they do not follow 
correct rules as to eating and drinking. 

In grown up and sensible people it does not happen that they sim- 
ply eat too much; this is far more frequently seen in children, 
especially among such as have their diet very much restricted, and 
hence are never satisfied but embrace every opportunity to overload the 
stomach. Children at the breast hardly have any feeling of satiety. 



146 CATARRH OF THE STOMACH. 

When nourishment is plenty they usually drink till the stomach is 
overfilled. If they vomit easily, the overloading is soon removed, 
and only so much nourishment remains as they can readily digest; if 
they do not vomit easily, the stomach remains overfilled, and they 
are affected with gastric catarrh, although they have taken the most 
suitable nourishment. Nurses know very well that children which 
vomit often and easily sicken less readily and thrive better than others. 
Catarrh of the stomach may also be excited by moderate use of 
food, which is hard to digest. The indigestibility of food often 
depends on its shape. Persons who eat with avidity, or who have no 
teeth, often introduce perfectly digestible food into their stomachs, in 
a state so that the gastric juice cannot get at it, and which is then 
slowly absorbed and digestion is retarded. The white of the hard 
boiled egg and fat belongs to this class of food. It is also caused by 
eating and drinking food that has begun to decompose before enter- 
ing the stomach. It may be thus caused in grown people if they 
partake of spoiled meat or beer, but it is more frequently in children 
from the use of milk that has began to sour. This is what renders the 
nourishment of infauts, by artificial means, so difficult in hot weather 
when the milk begins to spoil so soon. If children do not have their 
mouths regularly cleaned, or if a sugar teat be given them to prevent 
their crying, the decomposition of good, fresh cow's milk, or even of 
the mother's milk, may be commenced in the mouth itself. (Just think 
of it ! How carefully milk cans and dishes must be cleansed and 
purified of all decomposiing substances in order to prevent the milk 
from spoiling.) If decomposition has once begun in the milk in the 
stomach, the best milk taken subsequently will act as a poison, as it 
also begins to decompose. 

Acute catarrh of the stomach may also be caused by irritation from 
taking into it very hot or cold articles, some medicines, alcohol and 
spices. Alcohol acts most injuriously and should be only taken when 
prescribed by a physician in special cases. Spices in very small 
quantities aid digestion, while, taken in large doses lead to gastric 
catarrh. 

Catching cold also has a tendency to cause catarrh of the stomach. 

Symptoms. The tongue is generally coated, the taste stale and 
slymy and bad breath, also moderate fever. If the patients fast, and 
do not expose themselves to any new sources of injury until the 
stomach is able to fulfil its normal functions, the above symptoms 



CHOLERA MORBUS. 147 

usually disappear quickly. The abnormally, decomposed contents of 
the stomach pass through the pylorus into the intestines ; the secre- 
tion of the irritated intestinal mucous membrane increases, the move- 
ments of the bowels are hastened, flatulence rumbling, etc., with 
griping pains in the belly, occur, and are relieved by the passage of 
badly smelling gas; finally one or more pulpy stools occur, and the 
trouble ends. If the patient sleeps the following night, his general 
health is usually improved, or fully restored. During the affection 
the urine usually contains some coloring mass making it more dark 
than usual. 

When the injuries, that excite the acute gastric catarrh are more 
intense, or the patient more sensitive, there is greater nausea, which 
finally increases to retching and vomiting. By the latter the contents 
of the stomach are evacuated, more or less changed, with a very acid 
smell and taste, and usually mixed with a quantity of mucus. The 
vomiting may be repeated at varying intervals, the longer it lasts the 
more the matter vomitted is mixed with bile, which gives it a bitter 
taste and green color. These severe forms of catarrh of the stomach 
are almost always accompanied by great irritation of the mucous 
membrane of the intestine. Then there is severe diarrhea, by which 
green ma'sses are passed, with or without pain. After vomiting and 
purging, the patient is almost always relieved, and, although, perhaps 
a little feeble, is usually w r ell otherwise in a few days. If the vomit- 
ing and diarrhoea be very bad and continues, the symptoms are those 
of cholera morbus, by which is meant, that the gastric catarrh extends 
to the intestinal mucous membrane. 

Cholera Morbus, prevails most during the hot summer months, 
and then often attacks a number of persons simultaneously. It is 
seldom excited, at other times, and then by errors of diet. The cholera 
attacks are rarely preceded by premonitory symptoms; on the contrary, 
the patient is usually attacked suddenly, often during the night, with a 
disagreable feeling of pressure at the pit of the stomach, which is 
soon followed by nausea and vomiting. At first the food last eaten 
is vomited, little changed, but the vomiting is soon repeated, and 
quantities of pale green or yellowish fluid are thrown up, and v^ry 
bitter to the taste. After this, or sometimes during the vomiting, a 
rumbling noise in the bowels is perceived, and followed by pulpy 
stools, which soon become thin and liquid. In a short time enormous 
quantities of fluid are evacuated, the greater the amount, the less 
color it has, as the bile no longer suffices to color all the mass passing 



148 CHOLERA MORBUS. 

from the body. The loss of water from the blood excites intense 
thirst, which is only temporarily quenched by large quantities of 
drink. The fluid taken into the stomach is rapidly evacuated, either 
upward or downward. Through the loss of all this fluid, the blood 
becomes constantly thicker, the secretions, especially of the urine, be- 
come diminished, or ceases entirely. The skin appears dry and 
shrivelled, the patient looks collapsed and disfigured, the nose is 
pointed, the eyes sunken, owing to the loss of moisture in the connect- 
ing tissue. While there is rarely pain in the abdomen, there are very 
painful contractions of the muscles, especially in the calf of the leg. 
No matter how threatening the symptoms, how great the collapse 
and depression of the patient, the attendant must not feel 
discouraged, for it is of extreme rare occurrence that a previously 
healthy adult dies of cholera morbus. Usually, after a few hours, 
rarely not till the next day, the vomiting and purging subside; the 
skin becomes warm and full, the exhausted patient falls asleep, and 
only suffers from great depression. In the rarest cases, and only in 
sickly and weak persons, or in children or old persons, occurs some- 
times a fatal termination; then the bowels become paralyzed, the 
vomiting and purging cease, while the transudation continues; the 
pulse disappears, the movements of the heart become weaker, the 
intellect cloudy and the patient dies of exhaustion. 

Gastric catarrh during the first years of life presents certain pecu- 
liarities. The appearance of the child is little changed, at most it 
only looks a little pale and has a slight ring around the eyes. Almost 
always, shortly after nursing, there is vomiting and the milk thus 
evacuated is not curdled. This sort of vomiting is an important 
symptom, and is so recognized by both physician and nurse and is a 
sure sign of gastric catarrh. Soon after the vomiting, or even at the 
same time, the passage from the bowels becomes abnormal; the stool 
consists of a very acid, green or greenish-yellow fluid, containing 
more or less firm lumps, they remind us of the changes that the milk 
undergoes, after standing for some time, and shows that the gastric 
juice has not even digested it enough to cause coagulation. The 
vomiting and purging, which are usually preceded by restlessness of 
the child, by crying and drawing the legs up towards the belly, occur 
more or less frequent; and the stool often changes its consistency and 
color. In the majority of cases, the vomiting ceases after a few days, 
the undigested milk disappears from the evacuations, the children 
improve and pick up. When the disease runs a favorable course, the 



CHOLEEA INFANTUM. 149 

evacuations become fewer and more normal, the collapse disappears, 
the temperature becomes more even, the child improves and con- 
valesces, but a great tendency remains to relapse. 

If, however, the vomiting and purging does not stop, the tempera- 
ture is uneven, the trunk and especially the belly are burning hot, 
while the face and limbs are cold, there is danger. The little 
ones become sluggish in their movement, even nursing troubles them; 
they let go of the breast, but eagerly drink water, when it is offered 
to them. The cries of pain which usually precede the evacuations 
gradually change to weak whimperings ; in the interval the child lies 
half asleep. As the exhaustion increases, many die; occasionally, 
shortly before death, convulsions appear. 

Cholera Infantum. If the last described symptoms appear very 
rapidly, and the evacuations come one right after the other, if decided 
collapse occurs in a few hours, with great depression of the bodily 
temperature the disease is cholera infantum.. The thickening of the 
blood which has taken place in the body, is shown by the unquench 
able thirst; older children follow the glass of water with eager eyes, 
and when it is offered to them, seize it with both hands and hold it 
tightly until it is emptied. The patient may die in a few hours from 
this disease, with the above symptoms; in other cases, the cholera 
proper passes off and a milder form of catarrh of the stomach remains ; 
and, finally, in other cases, rapid and complete recovery takes place 
from conditions which are apparently utterly hopeless. 

Treatment. From the foregoing remarks you will see that in order to 
-avoid gastric catarrh, the diet of some persons, as of fever patients 
and convalescents, but particularly of infants, must be carefully 
watched. In the latter case, where it is impossible to give the child 
the- breast of the mother, or a healthy wet nurse, certain precautions 
must be exercised in the choice of cow's milk, and the following rules 
should be observed : 1st. The milk must be strictly fresh for night food 
morning's milk will not do. 2d. Milk from cows fed on oilcake or 
distillery swill must not be used. 3d. The milk should be sufficiently 
diluted; the first three months with two parts of water, the next three 
months half and half. 4th. It should be given at regular, and not too 
short, intervals. During the first two weeks the bottle may be given 
every two hours, later, every three or four hours. 5th. The vessel 
from which the child drinks, as well as its mouth, should be carefully 
cleaned. Neglect of any of these rules may lead to gastric catarrh or 



150 CHOLERA INFANTUM. 

cholera infantum, while the observation of them will prove protection 
for the child against the disease. 

If the child shows that it is suffering from gastric catarrh, by the 
characteristic vomiting, prepare the following: Of tincture of rheu- 
barb, bottle No. 26, one-half teaspoonful; bi-carbonate of soda, bottle 
No. 4, one teaspoonful; granulated sugar to suit taste, not too much, 
however; pure boiled water, one tumbler full. Mix well and give one 
teaspoonful every two hours. Only in aggravated cases should it be 
given every hour. 

It is exceedingly difficult to manage the diet of children with acute 
gastric catarrh, which has been caused and is kept up by decomposi- 
tion of the contents of the stomach. Milk, which is the most suitable 
and natural food for children is injurious to them in these cases, be- 
cause it quickly decomposes. Oat and barley gruel and the other 
starchy foods sour just as quick as milk. Under these circumstances 
you should remember that the children do not, in this condition, suf- 
fer from hunger, even if we withdraw all nourishment for a day or 
two, and feed them on fresh water alone, avoiding even the addition 
of sugar. "With the aid of the medicine above prescribed the vomiting 
and purging will cease, and it will look as if the fasting child was 
recovering. Then commence to feed it with small quantities of diluted 
fresh milk. If this be rejected again and again, and you fear danger 
to subject the child to longer abstinence, give it a teaspoonful of beef 
essence, which is prepared by cutting lean beef into very small cubes, 
placing these in a bottle (without adding water) closing it securely 
and leaving it in a vessel of boiling water for several hours. The 
collected juice is the essense. Grown persons suffering with gastric 
catarrh should endeavor to vomit by natural means which will always 
ease them and eat as little as possible and only fluid food, avoiding 
strictly, all alcoholic or malt stimulants. Under a careful diet as to 
eating and drinking, nature will restore the afflicted stomach very 
readily. 

Is the gastric catarrh the consequence of too much wine, beer, 
whisky, cider or anything in that line, and you have sour belching, 
take of bi-carbonate of soda, bottle No. 4, as much as will lay on the 
point of a penknife in a teaspoonful of water; repeat if not better in 
half hour. 

If purging continues give of essence of peppermint, bottle No. 27, 
10 drops in water. The patient should keep his feet warm by applying 



ULCEUS OF THE STOMACH. 151 

hot bricks and should take freely of the oatmeal and barley prepar- 
ation heretofore described, also liquid bread will do him good. During 
convalescence the patient should be careful of his diet, using light, 
digestible nourishing food, keep himself warm, guard against exposure 
to cold and damp and avoid all kinds of intemperance. If in case of 
acute gastric catarrh, the use of alcoholic stimulants is insisted upon 
by the patient, the disease usually develops into a chronic state which 
is very difficult to cure, unless the use of alcohol is discontinued. In 
such case the patient, when he is thirsty, should drink buttermilk, 
and when hungry do the same, in fact live for a while on buttermilk 
exclusively and his stomachial catarrh will be something of the past. 

Ulcer of the stomacli is caused by poverty of the blood and allowing 
gastric catarrh to run along without checking it. 

It occurs exclusively at the pit of the stomach and if not taken care 
of will eat through the walls of the stomach and thus permitting the 
escape of the contents of the stomach into the abdominal cavity, and 
thus cause fatal peritonitis. In this case they are called round 
perforating ulcers, severe vomiting, occurring regularly after meals, 
render it very probable that there is an ulcer of the stomach; the 
diagnosis is rendered certain if there be also vomiting of blood. 
Some patients with- ulcer of the stomach have decided swelling in the 
stomachial region, and complete loss of appetite. Eegarding the 
general health of the patient, ulcer of the stomach will soon impair 
the nutrition, so that the patient is rapidly debilitated and has a pale 
chachetic look. , 

Except in the first mentioned case, where the round ulcer proves 
fatal in a few days or weeks, the course of the disease is usually very 
tedious, and it may run on for years, the patient suffering many 
alternations of comfort and distress. Not infrequently in the midst of 
apparent convalescence, vomiting of blood suddenly occurs, or the 
affection returns with its former severity years after it had disappeared. 
Kecovery is the most frequent termination of chronic ulcers of the 
stomach. 

The sufferings of the patient gradually subside, the nutrition is 
fully restored and all disturbances cease. 

Treatment. Dietic rules best answer the indications from the disease, 
The result of the treatment mostly depends on their being strictly 
followed out. Of course you cannot protect the affected portion of 
the stomach from injury, as we can an ulcer of the skin; the intro- 



152 CANCER OF THE STOMACH. 

duction even of the mildest food excites the mucous membrane and 
irritates the affected part, however, the coarser and rougher the par- 
ticles placed in the stomach, the greater the irritation they excite. 
From this fact, proved by experiment and confirmed by practice, the 
rule is deduced, that the patient should have the mildest possible, 
and preferably a liquid diet. You had best try at first an exclusive 
milk diet and see if it will be borne, which is not always the case. If 
it comes up, add to the next some stale white bread. There is how- 
ever, some patients who cannot stand fresh milk at all, but have no 
difficulty with buttermilk or sour milk. If the patient has a natural 
aversion against a milk diet, give him rice soup, as heretofore describ- 
ed, and add to it some meat extract. Trommer's malt extract con- 
tains the nutritious constituents of malt in a state of solution, and is 
to be recommended because several spoonfuls of it may be taken daily 
without difficulty, hence it must be regarded as a valuable remedy. 
[If you cannot procure same in your neighborhood, write to the pub- 
lishers of this work and they will furnish same to you at cost price.] 
Vegetables, bread from unbolted flour, roast or fried potatoes are 
particularly to be avoided, while potatoes mashed with milk do very 
well. 

Very much benefit can be derived by taking in the morning of Bi- 
Carbonate of Soda, Bottle No. 4, as much as will lie on the point of a 
penknife in a teaspoonful of water. Breakfast should then be taken 
after an hour and a half and supper not later than six p. m. 

A complete cure can also be effected by visiting the thermal springs 
at Karlsbad, Bohemia, and drinking its waters. For persons, who 
are unable to do this, the bottled water from these springs can be 
purchased any where. It should be taken warmed and early in the 
morning one to two hours before breakfast, on an empty stomach. 

Cancer of the Stomach. Of the internal organs, the stomach is the 
one most frequently affected with cancer, the cause of which is very 
obscure. Men are more frequently affected than women, and usually 
between the ages of forty and sixty years. It most frequently attacks 
the pyloric portion of the stomach. 

Symptoms. Cases occur where it is impossible to recognize cancer 
of the stomach with certainty during life. In other cases an ap- 
proximate diagnosis of cancer can be made. The patient, if far ad- 
vanced in life, complains of loss of appetite, of a feeling of pressure 
and fulness in the vicinity of the stomach, and with these, rapidly 



DYSPEPSIA. 153 

loses strength, requires a dirty yellow color of the face. It takes a 
good physician to niake a complete diagnosis of the case, and to ad- 
minister such paliatives as will ease the sufferer. This is also to be 
recommended for the reason that the relatives need not reproach 
themselves, for having failed to do their duty. The only termination 
of cancer of the stomach is death. 

Spasm of the Stomachy is a painful nervous affection of the stomach. 

Symptoms. Suddenly, or after a precedent feeling of pressure, there 
is severe, griping pain in the pit of the stomach, usually extending to 
the back, with a feeling of faintness, shrunken countenance, cold 
hands and feet. The pain becomes so excessive that the patient 
cries out. The abdomen is either puffed out or driven in. 
The attack lasts from a minute to half an hour; then the 
pain gradually subsides, leaving the patient much exhausted, or else it 
ceases suddenly with eructation of gas or watery fluid, with vomiting, 
with a gentle, soft perspiration, or with the passage of reddish urine. 

Treatment. Give at once five drops Tinctiwe of Valerian, Bottle 
No. 21, in a teaspoonful of water, and as soon as pain lets up a little, 
administer one pill Assafoedida 2 gr., Bottle No. 20. It is also well 
to apply hot woolens to the stomach during attack. Light diet for 
three or four days and an occasional hot foot bath will prevent return 
of disease. 

Dyspepsia is state of the stomach, in which its functions are disturbed 
without the presence of other diseases, or if others are present, they 
are of minor importance. It is caused by irregularities in diet, such 
as indulgence in the luxuries of the table, partaking of rich, highly 
seasoned, heavy food. Eating too hastily and chewing the food badly 
are also causes. It can and is frequently induced by drinking too 
much coffee, tea or alcoholic liquors. Insufficient bodily exercise, 
excessive bodily or mental exertion, late hours, exposure, business or 
family troubles, and other disturbances, either bodily or mentally, 
have a tendency to fasten this most disagreable disease upon a person. 

Symptoms. They vary greatly, both in character and intensity, but 
there is commonly one or more of the following: Poor appetite, 
flatulence, nausea and eructations, bringing up acid or bitter fluids 
from the stomach, coated tongue, foul taste and breath, heartburn, 
pain, sensation of, fulness, after even the lightest meal, irregular 
stool, headache, diminished mental energy, low spirit, palpitation of 
the heart and a general uncomfortable feeling. 



154 DYSPEPSIA. 

The different forms of dyspepsia may be included under two heads ; 
the digestion is impaired either because the gastric juice secreted is of 
abnormal quality or because the movements of the stomach are dimin- 
ished, and consequently the food in the stomach is not sufficiently 
mixed with the gastric juice. Digestion, which is a clearly chemical 
process, can only be influenced by the nerves when they modify the 
secretions, or the movement of the stomach, and in this sense we 
have nervous dyspepsia. 

Treatment. Above all, a mode of life that improves nutrition and 
the occasional taking of a pill of Bland's Ferruginous, bottle No. 18, 
and bathing in salt water, either at home or on the sea coast, lots of 
out door exercise has a beneficial effect. If the dyspepsia is accom- 
panied by irritability or sensitiveness of the stomach, take a handful 
of hops and steep it in boiling water, and take of it after cooling tea- 
spoonful doses. In cases where the food lies undigested in the 
stomach it shows that there is a scanty secretion of gastric juices, 
which the large majority of people try to help along by taking large 
quantities of spices ; while this may help in the beginning, the stomach 
will soon become used to it and no benefit is derived from the same. 
In such cases take immediately after meal one two grain granule of 
pepsin sacharat, bottle No. 21, which will dissolve the food placed in 
stomach. 

When dyspepsia is noticed in the beginning of the ailment, the 
following plain remedy will usually effect a lasting cure, but not, 
however, if the disease is of long standing. 

Essence of peppermint, Bottle No. 27, one teaspoonful ; 
Bi-carbonate of soda, Bottle No. 4, one teaspoonful; 
Pure water, three-quarters of a tumblerful. 
Mix wel] and cover. 
Take of this mixture one tablespoonful 30 minutes before each meal 
and on retiring at night. 

Sufferers with dyspepsia should carefully observe the following rules : 
Mental or bodily work should not be resumed immediately after a 
full meal, it is also very injurious to set down to a meal, when com- 
pletely exhausted from work. Always rest yourself for a few minutes 
before you eat. Take plenty of gentle, healthful exercise, eat your 
meals at very regular hours and nothing between meals ; use no tobac- 
co, tea, coffee, and alcoholic drink; avoid mental excitement. 

Hot bread and biscuits are seeds of dyspepsia, they must be stricken 



INTESTINAL CATARRH. 155 

from the bill of fare. Do not drink, more, than you positively must 
a: meal times, and then have the liquid you take slightly warmed. 

Dyspeptics should as a rule avoid all vegetables except rice boiled 
nearly to a jelly, and potatoes both sweet and irish, they are best 
baked dry. Of perfectly ripe green fruit and stewed dried fruit, the 
patient may partake moderately. Fresh milk and buttermilk is good 
food for dyspeptics, All fresh meats, but the lean only, if broiled or 
roasted without fat is the best food for the patient, pork of course 
must be eliminated from the list. All meats should be kept in a cool 
place for some days before being cooked. Milk and hot water and 
w T eak black tea are the best drinks for dyspeptics. 

Intestinal Catarrh, or inflammation is one of the most frequent of 
diseases and is usually accompanied by liver troubles. 

Symptoms. In accute intestinal catarrh, besides cold perspiration, 
there is acceleration of the movements of the intestines, so that the 
passages are not only more fluid, but they become more frequent. 
Diarrhoea which is often preceded by rumbling in the intestines is the 
most constant, and occasionally the only symptom of intestinal catarrh. 
Pain and other symptoms may be absent, evacuations should not be too 
copicus and long continued. In such cases, diarrhoea must not be 
considered as a favorable sympton, and that it has a tendency to 
cleanse out the body. The color of the fluid passed is usually some 
shade of green owing to the bile being passed off with the stool. In 
some cases there is besides- diarrhoea, pains in the abdomen. These 
are chiefly periodical attacks of griping pain or colic, during which, 
if the pain be severe, the patient becomes very pale and cool. These 
colicky pains, usually subside, when a discharge from the bowels has 
just taken place, or is about to occur. In acute intestinal catarrh the 
abdomen is somewhat prominent, and quantities of badly smelling 
gases escape with the passages. It is usually caused by disturbed 
digestion and catching cold. 

Treatment. If the result of cold the patient should be put to bed, 
should take one teaspoonful of essence of peppermint, Bottle No. 27, 
two teaspoonfuls of sugar and one cup of boiling hot water, drinking 
the mixture as warm as possible, repeating the dose in half an hour 
if not relieved. The abdomen should be covered with warm woolens. 
Children up to ten years, one quarter of above dose, up to fifteen , one- 
half, others full dose. Patients suffering from chronic intestinal 
catarrh, caused by damp, cold climate, should wear woolen stockings 



156 CONSTIPATION. 

and flannel bandages around abdomen. When chronic intestinal 
catarrh in children is due to improper nourishment, the casual indi- 
cations require the regulation of the diet, and attention to this will 
often be crowned by brilliant success. While the diarrhoea lasts, the 
child will rarely stand a milk diet, meat broths suit best, but still 
better, finely shaved raw beef, taken with a little stale white bread or 
toast. Under this treatment, the diarrhoea, which had previously 
withstood all remedies, often ceases in a short time, and the emaciated- 
child soon recovers If the stool in the beginning of the 
disease is sluggish and it feels as if a plug was lodged in rectum, 
let grown people take one Pill Cathartic Comp. Vegetable, Bottle No. 
17, at bed time; for children an injection of warm water will answer 
the purpose. If after applying the remedies here given, the diarrhoea 
has continued for, say twenty-four hours, it must be stopped and the 
following plain remedy will invariably do it. 

Take two tablespoonfuls of flour and parch it in a skillet till it is of 
a rich chocolate color, (do not let it burn,) add to it one pint of boiling 
water and stir smooth, or put it through a fine strainer, season with a 
little salt. When it is luke-warm, allow patient to drink of it all he 
wishes, even to the extent of the whole dose. If they object to the 
taste, a little sugar makes it quite palatable, but if it can be taken 
without it, it is so much better. 

Ulcers of the small intestines. Is a similar affection as the ulceration 
of the stomach -end requires a like treatment. 

Habitual Constipation. Some persons habitually, only have a pas- 
sage every second or third day, and still feel very well, or feel worse 
when they have more ; on the other hand, others feel sick if they do 
not have one or two stools daily. The cause of this difference depends 
partly on the fact that the first form but little excrementitious 
matter, as they eat food, containing but little indigestible material, 
and as they perfectly assimilate the digestible part of the food; while 
the latter have a quantity of excrement, because their food contains 
much indigestible material, or because their power of digestion is 
impaired. Occasionally patients have an unsatisfactory feeling after 
stool; they feel as if there were still masses in the intestines, which 
should have been passed. This feeling alone gives them great dis- 
comfort, and puts them in a disagreeable frame of mind. Men with 
habitual constipation may have frequent erections and seminal emis- 
sions; if they were previously worried about their feelings, they are 



PILES. 157 

absolutely frightened by this symptom. The disease occurs more fre- 
quently in women than in men, and not infrequently develops in 
growing children. The bad habit of repeatedly restraining the faeces 
forcibly, induces habitual constipation in some cases. Sedentary 
habits are likewise properly classed among the exciting causes of this 
affection. Still it is remarkable, that perseveringly walking does not, 
by any means, render defaecation as easy as might be expected. 
Patients with habitual constipation usually become indefatigable 
walkers without thereby attaining the goal, which is often the object 
of their whole desire and endeavor. People, who have led a luxurious 
life often suffer from habitual constipation. We often meet persons, 
who in their youth, were most jovial and popular fellows, and, 
through a sedentary life, in a very few years, become ill-tempered and 
peevish, and have no thought beyond, whether they will have the 
longed for passage to-day. The excessive stretching and relaxation of 
the abdomen remaining afier frequent pregnancies, particularly after 
twins, nearly always causes habitual constipation. 

Treatment. It must be limited to a diet, which will leave little 
undigested matter. The patient should live on eggs, strong broths 
and pure muscular meat (lean only.) His stool must be forced by 
faequent injections of luke warm water and about once a week at bed 
time, two pills Cathartic Comp. Vegetable, Bottle No. 17. It will 
then soon mend. Children should be exclusively treated by dietary 
means, plenty of ripe fruit and lean meat. If the wanted stool does 
not come after two days, give a good dose of castor oil. 

Haemorrlioid.es or Piles is a varicose dilation of the veins of the 
rectum and bleeding from these blood-vessels. It is one of the most 
frequent of affections The varicosities of the rectum, or piles, as 
they are usually called, occur mostly at the anus and farther up, thus 
distinguishing external and internal or blind piles. At first the piles 
are very small, but later on they attain the size of a cherry or even 
larger. Bleeding piles are the result of ruptures of the varices from 
the force of blood pressing into the dilated vessels. 

Symptoms The patient has feeling of burning and tension in the 
rectum, just as occurs in other mucous membranes in acute catarrh 
or relapsing chronic catarrh. There are also severe paius in the 
lower portion of the backbone. The general state of the patient is 
disturbed, he becomes relaxed, sluggish and depressed. 

The local difficulties that the piles excite, vary with number, size 



158 COLIC OF THE INTESTINES. 

and fulness of the same. At first they are slight, the patients have the 
feeling of a foreign body in the anus, and pain only occurs when there 
is a hard stool. When the anus is is surrounded by large varices, or 
when individual tumors have become very large, and are very tense, 
the patients have constant pain, cannot sit down, and even a soft 
passage gives them great suffering, which only disappears slowly, and 
which not infrequently causes the patients foolishly to retain their 
passages. The pain becomes most severe when large variees are pro- 
truded through the anus, strangulated there, and become inflamed. 
The causes of the unpleasant feelings of the patient at one time, and 
his comfort at another, may often be discovered. The occurrence of 
constipation has obstructed the escape of blood from the rectum, or a 
debauch has overfilled the portal vein, the consequence of which is a 
congestion of the haemorrhoidal blood vessels. 

Treatment. The use of meat and egg food must be limited and the 
patient should eat only once a day a little of meat or egg. The diet 
should be of vegetables, fruit, well boiled rice and such articles. The 
patient should take long walks and indulge in energetic muscular 
exercise and drink plenty of pure water. The use of spirituous liq- 
uors of all kinds, tea and coffee must be stopped. If stool is diflcult 
let the patient take a good dose of salts. The patient should take 
every morning the following preparation : 

Take of sulphur, bottle No. 15, one tablespoonful, and of cream of 
tartar, bottle No. 6, one tablespoonful, mix well in dry state and add 
to it one cup full of pure sugar syrup ; of this mixture one teaspoonf ul 
should be taken every morning. The anus should be well washed at 
least three times every twenty-four hours, and if the piles protrude or 
are itching in the rectum, the following ointment should be used : 

Take of alum, bottle No. 1, one teaspoonful, and of vaseline, bottle 
No. 14, two tablespoonfuls ; mix well and apply to the diseased parts. 

Piles that have come down and been strangulated should be re- 
placed by continual careful pressure with a bit of oiled linen, while 
the patient rests on his knees and elbows, with the body bent forward. 
Inflamed piles should be covered with cold water compresses or blad- 
ders filled with very cold water. When piles will not succumb to 
above treatment a surgeon should be consulted with a view to have 
an operation performed. 

Colic of the intestine is a nervous affection of the intestines. 

Symptoms. There are attacks of pain spreading from the naval over 



WORMS. 159 

the abdomen, alternating with intervals of ease. The pain is tearing, 
cutting, pressing, most frequently twisting, pinching, introduced and 
accompanied by peculiar bearing down pains. The patient is restless, 
and seeks relief by changing his position, and in compressing the 
abdomen, his hands, feet and cheeks are cold; his features are pinched; 
the wrinkled brows and contracted lids betray his agony. The pulse 
is small and hard. The skin of the abdomen is tense, whether puffed 
up or drawn inward. There is usually constipation, but sometimes 
the bowels are regular, or even too loose. These attacks of colic may 
last from a few minutes to several hours, relaxing at intervals. It 
ceases suddenly, as if cut short, and there is a feeling of the greatest 
relief. 

Treatment. Give at once one Pill Assafoedida, 2 gr., Bottle No. 20, 
and one dose Phenacetine Bayer, 2 gr., Bottle No. 23. This will 
relieve the pain almost instantly, and within fifteen minutes after, 
give castor oil in large doses, say two tablespoonfuls, for a grown 
person, till the bowels are evacuated. The bowels should be kept 
warm, by means of hot woolens or warming bottles. The diet for a 
for a few days after an attack should be very light. 

Worms. The worms most frequently found in the human intestines 
are the tape worm, which is from ten to twenty feet long and of a 
yellowish white color. It is divided into head, neck and body, the 
latter consisting of many hundreds of links. The tape worm inhabits 
the small intestines, but may enter also the large. There are cases 
on record, where one person harbored more than one tape worm, 
however, only in exceptional cases. 

The round worm, is cylindrical, pointed at both ends, from six to 
twelve inches long and from two to three lines thick. The round 
worm inhabits the small and large intestines, but makes excursions 
in various directions and may enter the stomach and even the gullet 
and is then vomited. From the duodenum it occasionally makes its 
way into the bile ducts. They often occur in incredible numbers. 
When existing in large numbers, the worms cause much irritation, 
and are occasionally passed in balls rolled together. It is most fre- 
quent in ill fed children from 3 to 10 years of age. 

The thread or maw worm, is a small worm about as thick as twine. 
The head of the thread worm is enlarged by wing-like attachments. 
The usual seat of this worm is the lower part of the intestines, parti- 
cularly the rectum, they do, however, enter sometimes the small 



160 SYMPTOMS. 

intestines. They often crawl out of the anus and enter the vagina. 

These parasites living in the intestinal canal, originate from eggs, 
ank have reached the intestines in that state, or one further advanced, 
and are mostly carried to it by the use of indifferently cooked fresh or 
salt pork and the flesh of the goat. It is a well known fact that 
people, who abstain from the use of pork, such as Jews and Moham- 
medans, are never afflicted with tape worms, and when they are, it 
can always be traced to one of the transgressions of their religious 
code. 

Symptoms. The symptoms excited by intestinal worms vary greatly 
with the peculiarities of the person affected. Frequently there are 
no signs till worms, or fragments of worms, are passed at stool. This 
is chiefly true of tape worms. Many patients with tape worms enjoy 
the best of health, have neither stomach ache or other pain, and the 
links pass away, from time to time, and through it alone, their at- 
tention is called to the disease. In other cases, the patient complains, 
from time to time, of severe pain in the abdomen, which is usually 
described of a twisting and turning nature. By pressing against the 
abdomen the patient will have nausea and often vomiting. The 
secretion of saliva is almost always increased to such an extent that 
the saliva flows from the mouth. These attacks, particularly when 
they occur after eating herring (salt) onions, horseradish, or large 
grained fruit, are considered as certain signs of tape worms, however, 
before beginning treatment, these symptoms should be substantiated 
by the passing of links of the tape worm, while having a passage, 
either spontaneously or after the use of a laxative. In other cases 
again, the presence of tape worm is not so well borne, particularly 
after eating salty or spiced food, there is diarrhoea, and the patient 
becomes weak, pale and thin. This occurs particularly in persons 
previously debilitated, especially in children and young girls. 

The irritation of the tape worm may be reflected to other nerves, 
but the frequency of nervous affection from this cause has been much 
exaggerated. 

The sensation of tickling in the nose, which induces the patient to 
rub and pick that organ, dilation of the pupil, squinting, grating the 
teeth, and other unimportant disturbances of innervation, are rather 
attributed to the round worm, while the tape worm is blamed with 
more severe and extensive nervous affections, particularly epilepsy 
and St. Vitus' dance. Some hope may be entertained in epilepsy, oc- 



TREATMENT. 161 

curring without any perceptible cause, depends on irritation from 
worms, but be not too sure in the belief that the passage of links of 
tape worm from an epileptic patient proves that the disease depends 
on the presence of the worm, and will disappear with the removal. 

As a rule, the presence of round worms in the intestines excites no 
symptoms. They are so very common that, if the intestinal canal 
were much irritated, and nutrition greatly impaired by their presence, 
there would not be so many healthy and blooming children. If there 
be a large number of them in the bowels, they may curl up together, 
and form an obstruction, as hard faeces sometimes do, or cause colicky 
pains, if they do not uncurl or can not be removed by a dose of salts, 
they may induce symptoms of complete obstruction in the intestines, 
accompanied by an uncontrolable constipation and griping pain in the 
bowels. These round worms enter occasionally the stomach, as said 
before, and are the cause of great nausea and discomfort; the little 
patient cannot describe the feelings, and the mother is perplexed 
until a vomited worm solves the riddle. It has even happened that a 
worm in the stomach is quite unfelt, and may even crawl, unperceived, 
from the mouth during sleep. If the round worm finds its way into 
the bile duct, there occurs an obstruction and serious liver complaint. 

When the thread or maw worm approaches the anus, or crawls out 
of it, its incessant motions cause a very troublesome itching. This 
usually increases late in the evening, and during the night, and 
usually interferes with sleeping. Besides the itching there is an 
incessant desire to go to stool. In the evacuations, which are often 
mixed with mucus, the worms continue their shaky motions. If they 
crawl into the vagina, they cause annoying prickling and itching there 
also. The irritation from the worms and from the rubbing they 
induce, may cause catarrh of the vagina, and often mothers imagine 
that their little girls have the whites. 

Treatment. In case of tape worm it is essential and follows as a 
matter of course, that no pork should be eaten, under the same ban 
is raw sausage or goat meat. To successfully expel the tape worm a 
preparatory treatment is necessary. Let the patient live moderately, 
keep his bowels open with castor oil and let him live for a few days 
on salt herring, smoked fish, onions, horse radish and other salty and 
spicy food. If in season the patient should freely, eat of strawberries, 
huckleberries, raspberries, etc., the numerous seed of these fruits 
appear to sicken the worm. After having dieted in this manner, take 



162 GASTRIC FEVER. 

a half pint of pumpkin seeds to a pint and a half of water; steep to a 
pint; when cool drink one third of it, on an empty stomach, and bal- 
ance of the decoction in 2 or 3 hours doses. If the worm does 
not move repeat next day and follow with a dose of pill cathartic 
comp. veg., bottle No. 17, taking about 3 at a time. During this cure 
hardly any food should be taken. 

Turpentine, bottle No. 13, is one of the most certain remedies for 
tape worm, it should, however, only be used in case of necessity, not 
only on account of its disagreeable taste, but because in the 
requisite doses it is apt to irritate the urinary organs. It is 
administered as follows : After living for a few days upon the food 
above described, give from one to two ounces of turpentine alone, 
or mixed with honey or castor oil in one dose at bed time. It is a 
sure cure, but owing to the dissagreeable taste and interference 
wiih the urinary apparattus, the disease is about as easily borne as 
the cure. 

The publishers of this work are also in possession of a specific 
remedy for tape worm, but owing to its nature it has to be prepared 
fresh every time, as it will not keep longer than a fortnight, but 
they will be pleased to furnish it to any sufferer with tape worm, upon 
application. 

For round worms, give one granule of santonin, bottle No. 19, and 
follow it up with a dose of castor oil. 

The same treatment should be given in case of thread worms, but 
instead of the castor oil, give an injection of cold water, with a little 
pure cider vinegar in it. The injection should be a good large one in 
order to reach the farther portion of the large intestines, and be follow 
ed up until the stool shows no more worms. 

Gastric f eve? , Bile fever, is a disease running an acute course, in 
which high fever is accompanied by dyspeptic symptoms and diarrhoea^ 
while none of the important organs seem to be seriously affected. 

As a rule, gastric fever begins with several slight chills, rarely with 
a severe one. The pulse rises quickly to one hundred or more. The 
constitutional disturbances are very marked. The faintness is so 
great that the patient remains in bed; the limbs, particularly at the 
joints, pain "as they would burst." The insupportable headache is 
usually increased by laying the head on a feather pillow, while it is 
occasionally relieved by binding a towel firmly around the head. The 
patient does not sleep at all, but when he does, is disturbed by dreams. 



PERITONITIS. 16S 

The appetite is usually lost, the tongue coated, the taste slimy and bitter> 
the patient complains of a feeling of pressure and fulness in the 
stomach region, and is very sensative to pressure there. There is 
also eructation of gases and fluids, of an acid taste, occasionally there 
is repeated vomiting. At first there is constipation, but later, when 
the disease is protracted, there is diarrhoea, preceded by more or less 
colicky pain ; the stool is fluid and of a greenish color, caused by the 
passage of bile. 

Occasionally these symptoms pass off quickly, and the patient who 
is one day in a sad plight, feels quite' well the next. Often little 
blisters form around the corner of the month. The disease does not 
always terminate in one day, but often continues during several days; 
very seldom longer. 

Treatment. Give as soon as fever abates, one pill, comp. cathartic 
vegetable, bottle No, 17, and next morning after stool every two hours 
till 2 p. m., one pill quiniae, 2 gr., bottle No. 16. Light diet, well 
ventilated room; as a drink use oatmeal gruel with lemon juice. 

Sores on anus is often the case with fat people and if not looked after 
will form into fistules. 

Treatment. Take of carbolic acid 10%, bottle No. 5,onetablespoon- 
ful, pure rain or boiled water, 10 tablespoonfuls and wash with the 
mixture the afflicied part. This is also a good remedy for chafing on 
and around anus, and sexual organs. 

Cancer of the rectum is a very dangerous disease and is better left to 
the family physieian, little hope for a permanent cure can be 
entertained. 

Inflammation of the Peritoneum or Peritonitis is a very dangerous dis- 
ease and among the exciting causes are the following : 

Severe contusions and penetrating wounds of the abdomen, surgical 
operations, as for hernia and on the stomach. Ruptures or perforations 
of the organs covered by the peritoneum and the entrance of foreign 
bodies into the abdomtnal cavity. Thus perforating ulcers or cancer 
of the stomach, ulcerations of the vermiform process, for instance 
when seeds lodge in it, scrofulous ulcers of the intestines, perforations 
of the gall or urinary bladders, abcesses of the liver or spleen, all 
may cause this dangerous disease. In all such cases the inflamma- 
tion spreads with the greatest rapidity. It may also and in fact is, 
often caused by the spreading of inflammation from the female sexual 



164 SYMPTOMS. 

organs, and lastly, it may be caused from catching cold, this however 
is not the case very often in persons who have been previously healthy. 
In this latter case it is usually called rheumatic peritonitis. 

Symptoms. The same vary with the causes that induce it. 
Peritonitis, caused by wounds, usually begins with severe pain at the 
seat of the injury, which quickly spreads over the whole abdomen. In 
peritonitis from perforation also, excessive pain over the whole 
abdomen. In peritonitis from perforation has occurred suddenly and 
foreign substances have entered the peritoneum. At first along with 
the pain, there are symptoms of great general depression, and after 
it, there is a severe fever. The commencement of acute peritonitis, 
where the inflammation is propagated from neighboring organs is far 
less striking. The pain already existing is gradually increased; it is 
at first restricted to the seat of the affected organ, and thence spreads 
gradually over the entire abdomen. In rheumatic peritonitis it is 
only that severe chills and intense fever eccurs at the outset of the 
disease, No matter however, how the disease begins, whether there 
is fever at first or later on, or what its cause is, pain is always the 
most troublesome symptom. An slight pressure in the abdomen in- 
creases it, even the pressure of the bedclothes may become unbearable. 
The patient does not toss about in bed, as he does in colic, but lies on 
Iris back with the knees drawn up and dreads every change of position. 
The slightest cough causes a distortion of the countenance, from pain, 
the patient speaks low and carefully and does not breathe deep, fearing 
the incident pain. The abdomen soon becomes tense and puffed up. 
At first the distension depends but little on filling of the abdomen 
with exudation, and is mostly caused by distension of the intestines, 
which are filled with gas. In most cases of peritonitis the patient is 
obstinately constipated. If it is caused however from inflammation of 
the female sexual organs, there is usually watery diarrhoea. If such 
patient is set up in bed, or is pressed strongly on the abdomen, watery, 
slightly colored masses pass from the anus. Besides the foregoing 
symptoms, there is often vomiting. At first the vomited masses are 
mucus and colorless, later they are more watery, greenish or even in- 
tensely green. If the inflamed parts extend to the bladder, there 
arises an intense desire to urinate, and a feeling of fulness in the blad- 
der. Fever is one of the symptoms of the disease, and if it does not. 
begin with it, it occurs in the earlier stages. The pulse is very fre- 
quent and small with a very high temperature, often arising to 105 ° 
F. The general state of the patient is much affected, but the mind is 



CONGESTION OF LIVER. 165 

usually clear. In severe cases the above symptoms become very de- 
cided in a few days. But the pain is usually worse at first and subse- 
quently diminishes. The belly is inflated like a drum, the liver and 
the point of the heart are often pressed up as high as the third rib. 
The anxiety of the patient is very pitiful ; he beseeches aid, and looks 
perfectly desperate. Finally the mind becomes cloudy, the patient 
grows delerious, the pulse is smaller and more frequent, the body 
covered with cold sweat, and at the end of the first week sometimes 
even sooner, the patient succumbs to the disease. 

If the disease takes a favorable course, which usually occurs only 
when the physician succeeds in removing the exciting causes, or when 
these are not very grave, the pain and fever gradually subsides, respir- 
ation becomes freer and the patient may recover rapidly. But the 
disease, after recovery leaves its mark nearly always during life in the 
shape of habitual constipation and colicky pain before stool. 

Treatment. As soon as the first symptons show themselves give of 
one or in strong pain two doses Phenacetine Bayer 2 gr., Bottle No. 
23, which will alleviate the pain and send for a first-class physician, 
to direct further treatment. "While not a great deal of hope for 
recovery can be extended, even by the best medical practitioners, you 
have the conviction that you have done all you could, and when the 
patient passes away under the doctor's care, you need not make your- 
self any reproaches. The diet in case of peritonitis must necessarily 
be a very light one. Toast water; weak gruel and the like. 

Congestion of the liver. May be caused by determination of the blood 
to the organ or obstructed outflow from it. The predominant cause 
is the habitual use of alcoholic liquors, and excessive eating. 

Symptoms. Headache, difficult digestion, irregularity of the bowels, 
and a general uncomfortable feeling in right side. 

Treatment. Light diet, the use of alcoholic liquors must be aban- 
doned. Take at bed time one Pill Cathartic Comp. Vegetable Bottle 
No. 17 and after a a good stool, which will follow from this take one 
Quinine Pill 2 gr., Bottle No. 16, and thereafter exercise care in your 
eating and drinking. 

Imfiammation of the liver is a disease which is hard for a layman to 
-diagnose, as no certain rules and symptoms can be laid down for his 
guidance and the treatment of it should be left to a regular practition- 
er who understands his profession, and even the best of them generally 
make little headway. 



166 FATTY LIVEE. 

Syphiloma of the liver. Among the internal organs of the body, the 
liver appears the most frequently affected by constitutional syphilis ; 
syphilitic diseases of the liver is often found in children, who have 
inherited it from their parents. 

The disease can seldom be recognized during life and it is out of the 
question to treat same, and even if its symptoms could be established, 
remedies would be of no avail, as, in the best developed cases, it 
shows itself only towards the end and at a time when recovery is 
impossible. 

Attention is only drawn to the fact that parents cognizant of the 
disease in themselves, not only in liver, but general syphilis, commit 
a moral wrong, in being instrumental in the propogation of offspring 
who are doomed to suffering and early death, before they are born. 

Fatty liver. The circumstances under which a fatty liver occurs, is 
found along with an excessive production of fat throughout the body, 
where the supply of nutriment is excessive and its consumption limit- 
ed. As a usual thing persons affected with fatty Hver are chiefly 
those who excersise but very little, while they eat and drink a great 
deal. By this mode of life they are subjected to conditions analogous 
to those under which animals are placed with a design to fatten them. 

Symptoms. In most cases of fatty liver there are no subjective 
symptoms, and it takes a good physician to make a correct diagnosis. 
In fatty liver of a high grade, as occurs particularly in topers, there is 
usually a feeling of fulness in the right side. If the abdominal walls 
and the omentum be also fatty, the fulness of the abdomen and the 
tension of its walls may cause trouble in respiration. In such cases 
the secretions from the sebaceous glands is usually so increased that 
their skin shines with fat, and when the sweat, the perspiration runs 
from their skin in large pearls, this condition of the skin, which is 
due to the same state of affairs, as the fatty liver, may be mentioned 
as one of the symptoms. 

As fatty liver rarely causes any trouble, when in the lower or 
medium grade of the disease, not much notice is taken of it. In the 
highest grade it interferes seriously with the formation of the bile and 
consequently we find impaired digestion and the bile, not being taken 
from the blood, remains as a component part, causing other diseases. 

Treatment. In topers and gluttons, the indications imperatively de- 
mand a change of the mode of life. General advice is of no use, as it 
is badly followed. They must take hours of bodily exercise, must not 



JAUNDICE. 167 

indulge in afternoon naps, give careful directions about their meals, 
all gravies and other fatty substances of whatever nature, must be 
eliminated from their diet. For supper, at most a thin gruel and a 
little stewed fruit. The use of tea and coffee must be limited to next 
to nothing, and if they can possibly do without it, so much the better. 
Alcoholic liquor, wine, beer, hard cider, medicinal bitters, in fact any- 
thing, which contains the least bit of alcohol must not be touched or 
tasted. Medicines have little or no tendency to reduce the fat in liver 
and lasting benefit can only be derived from a change in mode of life. 
In case of costiveness endeavor to relieve it by the free use of fruit, or 
take every morning till relieved a pinch of cream tartar, bottle No. 6, 
in a tablespoonful of water one-half hour before breakfast. 

Cancer of the Liver, belongs to a class of diseases where cures are 
never effected, life may be prolonged but with it a terrible suffering. 
To avoid many disagreeable consequences call in the family physician. 

Jaundice, is an obstruction of the bile ducts in the liver. The gall 
ducts have no contractite element to urge their contents onward. The 
forces that pass the bile along its ducts are so weak, that they cannot 
overcome even the slightest obstacle, and a very inconsidereable ob- 
struction to the evacuation cf the bile suffices to cause it to collect in 
the liver, and thus induce retention of the bile. Pregnant women are 
frequently subject to jaundice. Catching cold, or the stoppage of 
periodical menses will also cause it occasionally. 

Symptoms. Yellow tinge, first of the whites of the eyes, thence at 
the roots of the nails and next the face and neck, and finally the 
trunk and extremities. The urine becomes yellow colored or even 
brown, and stains the linen; the stools are pulpy and cf a whitish 
grey color; there is usually constipation, lassitude, anxiety, pain in 
stomach, bitter taste and feverish symptoms. There are also, usually, 
depression of spirits, prostration of strength and slowness of pulse. 

Treatment. Bequires first of all, an improvement of the depressed 
state of the patient by a proper diet. Cold meats and strong soups 
are particularly well borne by patients suffering with jaundice. Fat is 
not absorbed when the bile does not enter the intestines, and conse- 
quently is not well borne, the use of rich gravies, bacon, ham, butter 
or anything of a fatty nature must be strictly avoided. In the next 
place, you must attend to constipation, from which most patients 
with jaundice suffer, and which partly depends on the dryness of the 
faeces, and partly on the absence of bile in the intestines. Children 



168 GALL STONES. 

and especially young girls should be given when in the least consti- 
pated ten drops of tincture of Eubard, bottle No. 26, in sweetened 
water and grown persons should take at bedtime one Pill Cathartic 
Comp., bottle No. 17. If the urine is very dark and its color is towards 
a greenish tint, give 5 drops Oil of Turpentine, bottle No. 13, 
alternating it with a small pinch of Cream of Tartar, bottle No. 6, to 
be taken in sweetened water. When the biliary obstruction has been 
removed bathe the patient in strong soap baths, which will relieve the 
itching sensation and lessen the jaundiced color of the body. 

Gall stones and their consequences. These so-called stones are hard 
substances, of an uncertain origin, which pass through the bile ducts 
into the intestines. 

Symvtom*. Gall stone colic begins unexpectedly and suddenly at 
the moment a concrement passes from the gall bladder to the bile 
duct and becomes packed in there. The patient is seized with a 
piercing or griping, insupportable pain, which starts from the right 
side and spreads over the whole abdomen, often also to the right 
chest and even to the right shoulder. The abdominal muscles are 
cramped and very sensitive to pressure; the patient sigh and moan, 
double up and roll about on the bed or floor. During all this there is 
no fever, but there are a number of other symptoms, the pulse becomes 
small, the skin cool, the face pale and distorted, sometimes the patient 
actually faints. In some cases the patients are affected with 
spasmodic trembling or chills; in other cases there are convulsions 
either general or limited to the right half of the body. There is most 
frequent obstinate vomiting. After a few hours, or in severe cases 
not till the next day, the sufferings of the patient are usually moderated 
and the general disturbances quited. This remission, during which, 
howhver, the patient still suffers severely, and still has a small pulse, 
and pale cool skin appears to correspond to the passage of the stone 
from one branch of the bile duct to the other, which is a little wider. 
However, the general symptoms do not change greatly till the stone 
has«entered the intestines. Then the patient is entirely free from 
pain and uneasiness, the pulse rises, the warmth of the skin returns 
and the distortion of the countenance disappears. Very rarely does 
gall stone colic terminate fatally. 

Treatment. At the appearance of the first symptom, give of Hoff- 
man's Anodyne, Bottle No. 25, 30 drops on a piece of loaf sugar or in 
some sugar water, let the patient have little pieces of ice, or very 
small draughts of ice water and put dry, hot woolen clothes on right 



TREATMENT. 169 

side, over the liver. Give an injection of luke warm water, about a 
pint, adding to it, twenty drops of Tincture of Valerian, Bottle No. 24, 
and see that the patient has in consequence a good passage, repeating 
the latter if he fails to have a voluminous stool. If in one hour the 
pain has not subsided, repeat the does of Hoffman's Anodyne, adding 
to it 20 drops of oil of Turpentine, Bottle No. 13, and if possible put 
patient into a warm bath, keeping him there for about an hour, adding 
hot water as it becomes cool. 

The main thing in this disease, however, is the prevention of 
repetition and it can only be regulated by the diet and a well regulated 
stool. All sweet things and fat must be avoided by the patient and 
especially should he avoid wheat bread, substituting rye or graham 
instead. Plenty out door exercise is also necessary. 

After an attack of gall stone colic a mild laxative, Tincture of 
Rhubarb, Bottle No. 26, one-half teaspoonful in sweetened water 
ought to be taken, in order that the system gets rid of the stone now 
lodged in the intestines. 

Injections of luke warm water are also to be recommended and 
may be substituted for the Rhubarb. 



Diseases 
Of the Respiratory Organs. 

NOSE. 

|V T OSE. Inflammation of the mucous membrane. Catarrh, acute and 
^1 ^ chronic. Cold in the head. Sore throat. The functional dis- 
orders characteristic of catarrh are to be seen frequently in 
the nasal mucous membrane, where they are usually called cold in 
the head, or nasal catarrh. Predisposition to cold in the head varies 
greatly in different individuals. As a rule, it is greater in children, 
and in feeble, delicate, and above all, in scrofulous persons, than in 
adults, and in individuals, who are muscular and robust. 

The causes, which occasion catarrh of the nose are very numerous, 
it is erroneous, however, that "colds" are invariably the cause. How- 
ever, numerous cases can be traced to it, especially to exposure of the 
feet, such as getting them wet, etc. 

Local irritants cause catarrh, such as entrance of hot air, dust, 
acrid gases or foreign bodies, or the snuffing of tobacco by persons 
not used to it. Blows and shocks, which the nose may encounter 
and often repeated and violent blowing of the nose are also causes. 

It may also be attributed to inflammations of mucous membrane of 
adjacent parts and spreading to the nose, such as boils on the upper 
lip or abscess on the upper gums. Nasal catarrh is also often a 
symptom of constitutional disease. That the disease is contagious is 
erroneous. 

Symptoms. For the reason that nasal catarrh is so generally known ; 
and, everybody, having had a personal experience of same, the sym- 
need here but brief notice. The patient first complains of a feeling of 
dryness and of a more or less complete obstruction in one or both 
nostrils, which induces a very prejudicial inclination to blow the nose. 



NASAL CATARRH. 171 

From time to time there arises a prickling sensation in the nose, and 
which usually precedes sneezing. The dryness of the nostrils is soon 
succeeded by a very abundant secretion, a colorless transparent watery 
liquid, of saltish taste, flowing almost incessantly from the nose, and 
sometimes forming an abrasion on the uppea lip. The senses of 
smell and taste become somewhat perverted and the tone of voice is 
nasal. In aggravated cases, the patients complain of a feeling of 
pressure or of distressing pain in the forehead. The redness and the 
swelling of the mucous membrane can be perceived as far as the eye 
can reach. A cold in the head is often complicated by eve troubles. 
The patients avoid the light and copious tears flow from the reddened 
eyes into the nostrils and over the cheeks. Should the back part of 
the mouth participate in nasal catarrh, there is difficulty in swallowing, 
if the air passages are implicated, cough and hoarseness accompanying 
the symptome. In strong cases of catarrh, a slight pain and roaring 
in ear, or a temporary hardness of hearing occurs. 

These symptoms, as described, are almost always accompanied by 
fever and general constitutional disturbances, particularly so, if the 
catarrh has spread over a great surface. The duration of nasal catarrh 
is usually short, and in most cases the disease terminates in complete 
recovery on the fifth, sixth or eighth day. It is very rarely, and only 
in scrofulous patients, that a cold in the head becomes protracted and 
changes from an acute to a chrynic catarrh. 

While acute nasal catarrh is a complaint as common as it is harm- 
less, it sometimes proves dangerous to infants at the breast, because 
their obstruction of their nasal passages, which are at all times nar- 
row, makes it difficult for them to suck. Babies with such affliction 
must be fed with a spoon. 

In chronic nasal catarrh we do not usually find the feeling of prickling 
in the nose, the sneezing and pain in forehead, also the fever is 
absent. The swelling of the mucous membrane, however, creates a 
permanent narrowing of the nasal passages and causes a more or less 
complete closure of one or both halves of the nose, by which inhalation 
of the air is impeded and the voice acquires a nasal tone. The secre- 
tion of the diseased mucous membrane shows a great tendency to 
putrify, whice causes the fetid odor to the air exhaled. Chronic 
catarrh of the nose is an extremely obstinate disorder, often defying 
all treatment and continuing for years, with varying intensity. 

Treatment. Keep the room for a day or two, and drink some very 



172 BLEEDING OE THE NOSE. 

hot lemonade from time to time, light diet, keep head and feet warm, 
not use silken or cotton handkerchiefs, but linen, change them fre- 
quently. Smear some vaseline, Bottle No. 14, on upper lip and at 
entrance of nostrils. At the out set of the disease, while the catarrh 
is hard yet, inhale hot vapors by breathing the steam from a teakettle 
or other vessel. In agravated cases, take a hot foot bath with a good 
handful of salt in it, take one pill quininae 2 gr., Bottle No. 16 and 
keep the bed. You will get well in a day or two. 

Infants at breast, who are yet unable to clear their nostrils, it will 
be necessary to free their nostrils of the obstructing secretion by syring- 
ing out the nose with luke warm water and to feed them by the bottle 
or spoon as long as the obstacle to sucking continues. 

In the treatment of chronic catarrh, if of a scrofulous nature, the 
patient should take for a month or two some cold liver oil. 

In bloated, flabby patient, who have a tendency to obetity, they 
must take for a week every evening one pill Cathartic Comp. Veg., 
Bottle 17, and drink cold water instead of intoxicating beverages. 
Local treatment should also be applied by taking some linen and 
pulling it into shreads, so-called charpie, and saturating it with 
carbolic acid 10% C. P., Bottle No. 5, then take of vaseline Bottle 
No. 14, and smear it well with it, tie around this small bundle a 
silken thread, securely, and shove the matter into one of the affected 
nostrils as high up as you can get it and especially to the diseased 
parts, leave it there for five or ten minutes and pull out by means of 
silk thread. If the chronic catarrh is in back part of mouth or throat 
make the f ollovdng gargle : The same should also be used in case of 
sore throat. To one glassful of luke warm water, add one teaspoon- 
ful of glycerine, Bottle No. 10, one teaspoonful carbolic acid, Bottle 
No 5, and one-quarter teaspoonful Chlorate Potash, Bottle No. 7. 
Mix till all if well dissolved in each other, and use the mixture as a 
gargle. By using persistently the nasal charpie and gargle you will 
feel improved in the first few days and by following this treatment for 
two or three weeks, your chronic catarrh will be something, only 
remaining in your memory. 

Polyps in the Nose. To remove these consult your surgeon. 

Bleeding at the Nose is a rupture of the capillaries of the nasal 
mucous membrane and is usually caused by pressure, internally or 
externally. Most people have never suffered from any spantaneous 
bleeding, save bleeding at the nose, and there are but few, who have 
never experienced it. 



TREATMENT. 173 

Symptoms. In many instances the haemorrhages are preceded by a 
sensation peculiar and somewhat like a rush of blood to the head and 
swelling of the nasal mucous membrane, so that, for sometime before 
the bleeding begins, the patients complain of stoppage of the nose or 
of a pressure in the forehead. The symptoms are more distressing 
than the bleeding. 

The symptoms of actual bleeding when once set in, requires no de- 
tailed description. Blood flows from both or from one nostril, either 
in drops or in a continuous stream of greater or less profusion. Should 
the bleeding begin, while the patient lies sleeping upon his back, the 
blood readily flows through the posterior part of the nose into the 
back part of the mouth. Part of it may enter the larynx and excite a 
cough and the patient, upon awaking, fancies, to his great terror, that 
he has had bleeding from the lungs. 

In other cases the blood is swollowed, enters the stomach and when 
afterwards vcmitted, may give rise to confusion with bleeding of the 
stomach. 

It is a well known fact that the longer nose bleeding lasts, the more 
obstinate it becomes; and often after a duration of three or four days 
it can only be subdued by means of the tampon or plug. In such 
cases of abundant and persistent bleeding from the nose, the visible 
mucous membranes, especially the lips and eyelids, where they join, 
assume a marked pallor ; the skin acquires a dirty white, waxy hue; 
the patients are extremely prostrated, complain of pain in head and 
back of neck, of uneasiness and of palpitation of the heart and readily 
faint away; and, should it not be possible to arrest the bleeding, a 
task, which, under such circumstances, is only to be accomplished, be 
most energetic interferences, death from loss of blood may ensue. 

Treatment. A moderate bleeding occuring in a vigorous person, 
particularly when preceded by symptoms, which abate when the 
bleeding begins, may be left to itself, as it will, generally, soon cease 
spontaneously. If the bleeding begins, may be left to itself, as it will, 
generally, soon cease spontaneously. If the bleeding be more profuse 
and begin to tell upon the person, or if the latter be already in a de- 
pressed condition, so that you may dread evil consequences, from even 
a slight loss of blood, warn the patient against aggravating the flow 
of blood by frequent snuffing and wiping the nose, and should apply 
to the nose and forehead cold compresses, or else cause him cautiously 
to snuff cold water, containing a little vinegar and Alum, (a pinch) 



174 LARYNX. 

Bottle No. 1, into the nostrils. As long as the bleeding continues, 
the patient must avoid all violent bodily motion. Persons subject to 
nose bleeding must stop the use of coffee, tea, hot soups, and other 
blood heating substances, and should drink qnly cold water with a 
few drops of lemon juice in it. 

Should this treatment be unsuccessful, if the patient in spite of it 
becomes weaker, should the blood begin to assume a brighter color, or 
coagulate slowh r , do not loose too much time, but proceed at once to 
prepare a simple tampon or plug as follows. Take of Alum, bottle 
No. 1, a good pinch and disolved it in one tablespoonful of luke warm 
water, and to it ten drops Carbolic acid 10% C. P., bottle No. 5, and 
saturate in this mixture a piece of very clean sponge, then lay over 
the affected nostril or both a piece of gauze and press it with the 
saturated sponge into the nostril or both as the case may be, using 
two pieces sponge in latter case, and shove this tampon as far as you 
can get it into the nostril, the gauze must be large enough that the 
corners protrude, so that you can take hold of it with your fingers. 
This tampon then can remain in nostril for 12 to 24 hours, and when 
you suspect that bleeding has stopped pull it out with a gentle jerk, 
by the protruding corners. This will effectually stop the bleeding. 
The patient, when with a tampon in his nose, should be put to bed. 

In grown people when the bleeding is yet within bounds, the appli- 
cation of ice to the testicles in man, and to the breast in woman has 
shown good results, but you should never wait too long till you apply 
a tampon. 

Sufferers with nose bleeding should drink lemonade or other cooling 
sour drinks, but avoid totally anything in the shape of alcohol. 

LARYNX. 

Catarrh. It consists of engorgement of the blood vessels of the 
mucous membrane, accompanied by abnormal secretion, swelling, 
succulence of the tissues, and copious generation of new cells. 

Predisposition to catarrh of the larynx seems to exist in persons with 
thin skin and those having a tendency to perspire; for those who 
sweat readily are the more apt to be suddenly chilled by the rapid 
evaporation of their perspiration. Badly nourished persons are less 
capable of resistance to the action of hurtful agents, and are on the 
whole, more liable to catarrh than full blooded and robust individuals. 
Effeminate habits seem to aggravate it. Thus we see country people, 



CATAERH OF THE LABYNX. 175 

farmers, etc., who live continually exposed to changes of temperature 
and to stress of weather, are less frequently affected with catarrh, 
than persons of sedentary habits, and those who are but rarely sub- 
jected to such exposure. 

The exciting causes are- local irritants, which act upon the larynx, 
such as breathing cold air, the inhalation of dust and acrid vapors, 
loud screaming, shouting, singing and violent coughing. If liquor or 
hot water should penetrate the larynx, the most intense form of 
laryngeal catarrh ensues. 

Chilling of the skin, particularly that of the neck and feet will give 
rise to this disease. 

Laryngeal catarrh often spreads from neighboring organs, such as 
from the nose, air tubes, etc. The back part of the mouth is often the 
point of origin. This is especially the case in that form of the malady 
induced by the abuse of spirituous liquors, which have a direct action 
upon the mucus membrane. Indeed we may often notice a hoarse, 
shrill voice, or other signs of acute laryngeal catarrh, coming on in 
consequence of a debauch, although the person affected may not have 
shouted or sang much. Hapitual topers almost always have catarrh 
in the back part of the mouth, in which the mucous membrane of the 
larynx takes part. 

Laryngeal catarrh is a common symptom of constitutional diseases 
resulting from injection or contagion. Measles, typhus, syphilitic 
disorders, are diseases which localize themselves upon the larynx. 

Symptoms. The patient first complains of a feeling of tickling, or 
in more severe cases, of a seneation of burning or soreness in the 
throat, which is aggravated by speaking or coughing, and swallowing 
becomes painful. Alteration of the voice furnishes a characteristic 
sign of the disease; it grows deeper, hoarse, cracked and finally be- 
comes inaudible. 

Besides the symptoms mentioned there is also a violent cough. 
Expectoration is scant, when the catarrh is confined to the larynx. 

It is not unfrequent by any means, that we see children who have 
been coughing a little during the day, and been hoarse without being 
ill, wake up and suddenly in the night with great oppression of 
breathing. The inspiration is troublesome and protracted, the terri- 
fied child throws itself about in bed, or springs up, clutches anxiously 
at the throat; the cough is hoarse ^and barking. These attacks are 
often confounded with croup, but usually vanish completely after a 



176 SYMPTOMS. 

few hours, or sooner. In such cases give the child some warm milk 
and put a sponge soaked in hot water upon their throat, plain remedies 
but sure to cut it short if given in time. Attacks like these are often 
repeated for several successive nights, while during the day the child- 
plays about, and, with the exception of a slight cough, seems perfectly 
well. 

As regards the course, durater and termination of laryngeal catarrh, 
expectoration generally appears after a few days, when then sensitive- 
ness of the larynx, the hoarseness, and the cough abate, the disease 
terminating by recovery at the end of about a week. 

During the day the patient is somewhat hoarse, but otherwise is 
well, with the exception that he is troubled by violent and protracted 
fits of coughing especially mornings and evenings. A fatal termina- 
tion is is one of the greatest rarities. 

This is however one of the diseases, which must be looked after in 
the beginning, if not, it is very liable to become chronic, and in that 
state it is very tedious requiring cautious and judicious treatment. 
Even after a cure has been affected, there is a strong tendency to 
relapse. 

Treatment. It is advisable, rather cautiously to habituate children 
to the causes of this disease than to enervate them by a systematic 
over-protection, which tends to increaae the liability to its attacks 
upon every trifling occasion. Do not shut up children in the house, 
even though they have suffered from laryngitis, but keep them in the 
open air. In bad weather let them be warmly clad, but their necks 
should never be over-heated with thick woolen shawls washing of the 
the throat in cold water and cold river bathing cannot be too strongly 
commended. 

In the cause of the catarrh be the direct action of some irritant upon 
the mucous membrane, the patient must be protected from it further 
influence. To guard the patient from further irritation of the larynx, 
let him be kept in a uniform temperature, regulated by the thermo- 
meter. Forbid all loud and continued talking or singing, and above 
all, urge the patient to resist the inclination to cough. Even thought 
not entirely successful in this, yet much may be gained by determina- 
tion on his part. The assertion that the patient cannot help coughing 
should never deter you from persistently telling him, not to cough. 
Cough drops are entirely useless an4 should be avoided. Caramels 
and licorice are not better and are of no use to bother the patient with. 



TREATMENT. 177 

When children are afflicted they should inhale the vapors of boiling- 
saltwater and be given very warm milk to drink. Rub a little oil of 
turpentine, bottle No. 13, on their necks and put over it some flannel. 
While asleep at night they must be aroused every hour or two in 
order to rid them of the accumulation of phlegm otherwise it will have 
a choking tendency and aggravtes the disease. Should the throat 
however fill up, run your finger or the handle of a teaspoon into their 
throat to induce vomiting, 

Grown people should take one pill Quiniae when the cough does not 
become loose and has a tendency to remain dry and hacking, in grown 
persons let them take one pill Terpin Hydrate, bottle No. 22, which 
has a tendency to loosen the cough and bring it to an early termina- 
tion, 2 gr. bottle No. 16 and keep the bed. Drink a glass of very hot 
lemonade, avoid draught and catching additional cold, by keeping 
well covered. 

When chilling of the skin, feet, or throat is the cause of the catarrh, 
sweating must be resorted to; The best and simplest of these is elder- 
bloom tea, or hot lemonade, and warmth in bed. Before retiring it is 
well to take a foot bath of hot water and salt, and wrapping the 
throat in a woolen stocking, hot poultices of corn meal around throat 
are also of much use, care must be taken, that they do not become 
chilled in removing the same. 

In cases where the catarrh has extended from the back part of the 
mouth into the larynx, gargles are very beneficial and are to be pre- 
pared as follows : 

To one glass lukewarm water, add one-quarter teaspoonful chlorate 
of potash, bottle No. 7, 1 teaspoonful glycerine, bottle No. 10, and 10 
drops carbolic acid 10% C. P., bottJe No. 5. Mix thoroughly and 
gargle while the mixture is still lukewarm. 

As to diet, all greasy substances must be avoided, but salt should be 
taken in liberal doses in all victuals. As to drink, milk or milk and 
water are the proper thing and far better than coffee or tea. It is 
evident that a person, taking alcoholic drink can never be thoroughly 
cured of this disease. 

With children afflicted with this disease, it is good rule to awaken 
them occasionally and give them a drink of warm milk or water and 
milk. This will often cause expectoration and thus prevent the ac- 
cumulation and drying up of the secretions in the larynx. 



178 CROUP. 

Croup. It is an inflammatory disorder, in which the fibrinous ex- 
cudations rapidly coagulate and are thrown out upon the free surface 
of a mucous membrane, involving, however the outer layer only. It 
is especially dangercus when these excudations are deposited in the 
air passages. 

Although peculiarly a disese of childhood, still the disposition to 
it is less during the period of suckling. After the second teeth have 
made their appearance, too, the disease is more rare, so that the 
greatest predisposition for croup lies between the second and seventh 
year of life. Boys are more subject to it than girls, but it is a great 
error to suppose that vigorous, full blooded, blooming children are 
especially liable. 

Croup is most common in northerly, windy damp places, bordering 
on the water; often it becomes epidemic. At such times many chil- 
dren are attacked even in one small settlement, and often several 
children of the same family in quick succession, and by the most in- 
tense and pernicious form of the disease. 

The exciting causes of croup are in most cases not to be explained. 
Cold nearly always occasions the disease. A sharp northerly or north- 
westerly wind stands in bad repute and is often the cause. 

Symptoms. The child is cross and feverish, is hoarse and coughs 
with suspicious tone. In all cases examine the back part of the 
mouth at once, although the child may not complain of difficulty in 
swallowing. Should you find them swollen, and spotted here and 
there with small, firm white patches, you have before you the unmis- 
takable form of insipient croup. 

These forerunners may precede the attack itself by one or two days. 
They are absent, however, in many cases entirely, the disease setting 
in suddenly and unexpectedly in all its terrors. Late in the evening, 
generally, or in the middle of the night, the child is aroused from its 
sleep with a harsh, hoarse, inaudible voice, the deep, soft note of 
which breaks into shrill, piercing discords, already frequently coated 
by excudations, come for an instant into contact. The cough which 
was soft and sharp in the beginning, soon becomes harsh, hoarse, and 
is no longer barking, except when a frequent effort is made to free 
the air passages. 

It is doubtful whether any real pain in the larynx forms a symptom 
of croupe. The clutching of a child at its throat may depend upon a 



TREATMENT. 179 

desire to remove the impediment to its breathing, which it instinctively 
perceives. 

Croup in a great many cases, exhibits decided remissions in the 
morning and through the course of day, which might almost seem 
intermissions. Toward morning the respiration becomes more free. 
The voice returns, the cough is less frequent; it is hoarse, but not 
without sound. The fever abates, the general condition appears 
almost undisturbed and only the thin piping, or still the suspitious 
tone of the cough remains to recall to mind the scene of terror of the 
the previous night. But beware of building too great hopes upon these 
remissions. The coming night may bring with it a repetition of the 
same symptoms, and the greatest danger to the life of the child. The 
continuance of fever, even if only moderate, and above all,the presence 
of those patches in the back part of the mouth, should excite the 
greatest solicitude. 

Children who have passed their seventh year may survive attacks 
of croup of the utmost intensity, but during the earlier years of life 
croup is one of the most formidable of all diseases. 

Among the symptoms, the terror, the restlessness, the full pulse, 
the flushed face, the hoarseness, are of far less importance than the 
first indications of blood poisoning, which commences when the child 
cannot exhale the air from the lungs. If the face grows pale, the lips 
colorless, the child drowsy, sensibilities benumbed; if an emetic 
remains without action, one is rarely justified in expecting a favorable 
termination of the disease. 

Treatment. Prevention is always cheaper than a cure, and the first 
remarks under treatment for catarrh of the larynx holds good in the 
case of croup. Never shut up a child permanently in its chamber 
because it has had once an attack of croup, nor accustom it to too 
much clothing. Mothers, however, should not deceive themselves by 
bright sunshine alone, nor to send the child out without paying atten- 
tion to the direction of the wind. Where there is decided predisposi- 
tion to croup; watch the weather cock, and keep the child from expos- 
ure to a rude north or northwesterly wind. It is also advisable to 
keep the child within doors after sunset. Finally, cold washing of 
the throat and breast provided that the skin be afterwards carefully 
dried, is a capital preventative, where there is a predisposition to 
croup. 

When the symptoms agree with those above given, it is advised to 



180 GROWTH IN LARYNX. 

send at once for the family physician, than the administration of such 
strong medicines becomes a necessity and which cannot be trusted 
into lay hands, even not unto those of the loving mother, It may 
also require the operation of tracheotomy or the insertion of the tubing 
into the windpipe to prevent suffocation and all these things require 
skill not generally found in a layman. However, while sending for 
the doctor, the child should be at once placed in bed and cold com- 
presses applied to throat and chest as soon as first signs of croup 
appears. Do not be afraid to apply these cold compresses and change 
them quite often. Besides this, if the bowels be confined, administer 
an injection, it will ease the breathing. The best is a cold one, of 
three parts of water and one of pure cider vinegar. 

However well the child may be, or seem to be, it must not leave its 
bed. The temperature of the room must be kept uniform and the air 
rendered moist by means of open vessels of water. 

Syphilitic disease of the larynx is a very common and nasty disease, 
and usually breaks out in the throat when the origin of the disease 
has advanced to the secondary or tertiary state. 

Symptoms. It commences usually with catarrh of the larynx, with 
ulcers therein. The unfortunates who contract the loathsome disease 
of syphilis and let it run till it breaks out tn the larnyx usually die 
sooner or later. Their whole system is so impregnated with this viru- 
lent poison, that hardly anything will check it. 

Inasmuch as the disease is one, which ought not to occur in a well- 
regulated family for which this work is intended, the subject will be 
thus briefly dismissed, with the advice to consult your family physician 
and to follow his directions. 

Growths in larynx can now-a-days be easily removed by the surgeon, 
who should be consulted with a view to an operation. 

Tuberculous laryngeal consumption or tubercular ulceration of the larynx 
rarely arises as an independent and primary malady, is one of the 
most common complications of the lungs. Not only does it accompa- 
uy the tuberculous form of pulmonary consumption, but is seen quite 
often in that form of consumption, usually regarded as a result from 
inflammation. 

Symptoms. When hoarseness supervenes upon symptoms of tuber- 
culosis of the lungs of long standing, you may confidently infer, also 
the existence of tubercles of the larynx. The hoarseness is occasioned 



SPASMS OF THE LARYNX. 181 

by the relaxation and thickening of the vocal cords, and by the secre- 
tion which lies upon then. You can thus understand why the hoarse- 
ness comes and goes, while the ulcers are growing and relax. 

The sufferer declares that there is nothing the matter with his chest, 
ridicules the diagnosis of the physician and protests that the only evil, 
with which he believes himself to be afflicted, or which he fears, is 
the consumption of the larynx. It is rare for patients to complain of 
burning or smarting in the larynx, and, usually, too, they are but 
slightly sensitive to pressure there. The shortness of breath, the 
hectic flush and fever, the night sweats, the emaciation proceed equally 
from the co-existing tuberculosis of the lungs. 

Examination of the back part of the mouth almost always shows 
that chronic catarrh exists there also. The sufferer hawks a great 
deal, deglutition is difficult. At last it is almost impossible for him to 
enjoy liquid food without choking himself, while solid food passes 
down more easily. 

Death takes place, in most cases, from exhaustion or with the sym- 
ptoms of consumption, which will be more fully described hereafter. 

Treatment. Follow about the same directions as given under the 
head of catarrh of the larynx, however, the results will be but small. 

Paliatives in the shape of narcotics such as morphine, must, of 
course be specially prescribed by the family physician. 

As a matter of course, the patient, whose larynx suffers from 
excessive irritability from tuberculous ulcerations, must remain in 
uniformly heated and if possible somewhat moist atmosphere. Forbid 
him all loud speaking, and in bad cases, compel absolute silence of 
weeks duration. Attention is invited to remarks on Tuberculosis of 
the Lungs and the Dr. Koch remedies lately discovered, which also 
hold good in this disease. 

Spasms or cramps of the Larynx. This disease depends upon a 
morbid excitement of the nerves, by means of which contractions of 
the muscles therein is effected. By uniform shortening of all the 
muscles at once, the vocal cords become tightly stretched, and the 
glottis is closed. These spasms occur almost exclusively during child- 
hood, and especially in the first year of life, and most frequently 
during first period of teething. Among children brought up by the 
bottle, it seems to be more common, than among those nursed at the 
breast. Among adults, none but hysterical persons suffer from these 
spasms. 



182 BRONCHITIS. 

Symptoms. The course of this disease, like that of most nerve 
troubles, is an interrupted one, marked by fits and interval of exemp- 
tions. A sudden, violent interruption of the respiration, which may- 
last for several minutes, is characteristic of the disease. By and by 
the air begins to penetrate into or out from the glottis, which at first 
is completely closed and still remains contracted. In addition to this 
the attack is accompanied by a prolonged whistling noise, the fear, rest- 
lessness, the livid countenance, the contraction of the inspiratory 
muscles and the position upright or bent forward. After a few 
minutes, as soon as the child has forgotten his fright, he is completely 
restored. There is no cough and hoarseness. Seldom but occasionally 
general convulsions may occur, in which the little sufferer may 
perish. 

The fits thus described take place at varying intervals ; a week or 
more may pass without their repetition. In bad cases the fits 
multiply, and follow one another more closely, and it is these cases 
that are most apt to be accompanied by genersl convulsions. There 
always remains a great tendency to relapse, which is still to be feared, 
even though a child has remained for months without a fit. 

Treatment. Endeavor most carefully to avoid all disorders of 
nutrition and of digestion in children who show a tendency to this 
malady. Children fed by the spoon or bottle, should be placed at the 
breast when they show tendency to this disease. 

During the fit it is impossible to give medicine, as the child is un- 
able to swallow, as soon as the fit begins, fan the child in fresh air, 
and gently rub its back and administer an injection of luke warm 
water with four drops of Tincture of Valerian, Bottle No. 24, in the 
same. This will bring the child around all right, but avoid all excite- 
ment to mother as well as child. 

Paralysis of the Vocal Cords causes cessation of the voice, mostly of a 
temporary nature, but not unfrequently of a long duration. It can 
be induced by contracting a severe cold. 

Treatment. Application of an electric current scientifically applied, 
is a sure and reliable remedy. 

Trachea and Bronchii commonly called windpipe and air tubes of the 
lungs. 

Catarrh or Bronchitis. The origin of catarrh of the windpipe and 
air tubes is similar to catarrhs of other mucous membranes, and here- 
tofore described. 



SYMPTOMS. 183 

Bronchitis consists of an inflammation of the lining membrane of 
the air passages. It is caused generally by taking cold, but, irregu- 
larities in the blood are also often accountable for it. 

Symptoms. Acute Bronchitis generally commences, like any other 
common cold or catarrh, with lassitude, chilliness, slight cough, op- 
pression and tightness of the chest, and sometimes with fever. There 
are cases, however, where, through the whole course of disease, fever 
is entirely absent. As the disease increases the symptoms do like- 
wise. And the countenance shows great anxiety. Respiration be- 
comes laborious, and is characteristic of a rattling or wheezing sound, 
as if the air going to or coming from the lungs was forced through in 
adequate apertures, or that they are clogged. The larynx being 
usually more or less affected, the voice is hoarse and speech laborious. 

Respiration is easier in a recumbent position, than in an erect one. 
At the outset of the disease, the cough is dry and hacky, but after a 
little while, a ropy, transparent mass is expectorated when coughing, 
which somewhat relieves the pains incident thereto. Towards the 
termination of the inflammation, the matter expectorated loses its 
transparency, and becomes mixed with yellowish, or greenish matter, 
scanty at first, but nearly composing the whole of expectoration as the 
disease progresses. There is severe pain in the forehead, greatly 
agravated, when coughing. Drowsiness often occurs, when the secre- 
tions of the mucus in the air passages becomes very voluminous. 
The tongue is white, and coated with transparent mucus. The skin 
dry and temperature only a little above the normal. 

Acute bronchitis is never accompanied by darting pain in the side. 
The only painful sensation proper to it is a feeling of soreness and 
burning in the chest and sensibility at the junction of the abdominal 
and chest muscles. When other pains arise, complications always 
exist. 

The danger of bronchitis depends almost entirely upon the age of 
the patient. In early life, the younger the child the smaller the air 
tubes, so much the more perilous is the disease. In adults it scarcely 
ever threatens life, excepting among old persons, where again it be- 
comes a dangerous disorder, especially if accompanied by fever. 

The gravest symptoms are those indicative of obstruction of the air 
passages. The most violent cough, the most intense restlessness, an 
immense expectoration, and all other symptoms of the acute and 
chronic form of this disease are of far less significance than the first 



184 TREATMENT. 

mentioned symptom. Do not forget, that life is not threatened till 
the air passages become clogged up with mucous, in such cases oxygen 
cannot get into the lungs and carbonic acid can not get out. The 
latter when accumulated, cause a poisoning of the system by carbonic 
acid. 

Treatment. What was said under this head in catarrh of the larynx 
holds good in this case as to prevention. Be cautious as to change of 
temperature, cold washing, cold bathing and a general hardening of 
the system cannot be too much commended. 

The patient should be kept in a warm atmosphere (68 to 70 ° ) 
which should be moistened by steam or evaporation of water from 
shallow dishes placed about the room. Ventilation of the sick- 
chamber must not be neglected by any means. 

Hot cornmeal or linseed poultices about one and one-half inch thick 
placed on chest and lower neck are very beneficial and prevent 
congestion. 

As to diet during attack, give barley or oatmeal gruel very thin, 
beef tea, jelly and warm milk. Cold water in small quantities is 
harmless. During convalescence, undue exposures must be guarded 
against until the constitution has been strengthened and been built up 
again. During this stage the diet should be nourishing but very easy 
of digestion. 

As soon as the attack appears, the patient should of course be put 
to bed, and be given a very hot drink of lemonade, sweetened if pos- 
sible, with strained honey, within half an hour after that, give him 
one pill quininae, 2 gr., Bottle No. 16. His bowels must be kept 
open by means of injection of luke warm water. 

In strong cases, where the disease seems to ba abnoxious to the 
above treatment, give of Terpin hydrat, 2 gr. Bottle No. 22, one pill. 
The effect obtained from this is always an increase and a liquefaction 
of the secretion, considerable reduction of the irritation and an easy 
expectoration. 

Children suffering with bronchitis should not be given any medicine, 
but the treatment by perspiration is highly to be recommended, 
especially where the bronchitis is recent, and particularly when cold 
is the assignable cause. By this treatment, the happiest effect upon 
disease of this nature is established by experience. The irritability of 
the mucous membranes can be diminished even in a few hours, and in 
fortunate cases, by profuse surating, you may succeed in cutting short 



ASTHMA. 185 

the bronchitis. Copious potations of hot lemonade and warm bed 
covering seem to be the most sure means. A very sure means of 
producing sweat is also, to wrap the child completely in a wet sheet 
and put it to bed, cover the little patient with lots of warm blankets. 
These cold applications, from the retained heat of the body itself, are 
very soon converted into warm ones. 

Children suffering habitual with bronchial affections should wear 
.flannel chest pretectors and when an outbreak of the disease noticed 
in the beginning, a plaster of mustard, oil heretofore described put on 
their chest, and by letting them keep the house for a few days will 
bring them around alright. Do not let the mustard plaster come to 
blisters, as soon as the skin becomes red, remove it and put a little 
Vaseline, Bottle No. 14, on the spot. 

Eubbing the chest with turpentine, Bottle No. 13, is also a very 
good remedy and worthy of trial, after rubbing, cover chest with 
flannel. 

In order to facilitate regular evacuations of the bowels in children, 
give give a few drops tincture of Eubarb, Bottle No. 26, in sweetened 
water, whenever they appear costive. 

Asthma, or cramps of the bronchial tubes is a nervous affection, 
which leads in cases of attack to severe fits, characterized by a severe 
difficulty in breathing. These fits alternate with intervals of exemp- 
tion. Asthmatic attacks sometimes follow one another with short 
pauses, for a while, and then subside, often, not to return for months, 
or even years. 

Sijmptoms. Should the fit come on during sleep, which it usually 
does, the slumberer becomes restless, and gives rise to the most 
frightful dreams. When the sufferer awakes, he has a great desire to 
draw a deep breath, but feels that the air does not penetrate into the 
chest beyond a certain point. Hissing, whistling, purring noises are 
audible, both upon inpiration and expiration, which are perceptible to 
a patient himself, and may often be heard even at some distance. 
The embarrassment increases the respiratory muscles, and even the 
auxiliaries are brought into action, the head is thrown back, and the 
arms are braced so as to expand the chest — but in vain. Terror is 
depicted upon the countenance, the eyes are widely opened; cold 
sweat bedews the forehead, the complexion is pale, the impulse of the 
heart violent, unequal, irregular; the pulse is small and weak; the 
temperature of the hands and cheeks is depressed. Such an attack, 



186 TREATMENT. 

after lasting for a quarter of an hour, or longer, with brief remissions, 
either ceases suddenly, the air rushing forcibly into the accluded air 
tubes and cells, causing weak breathing, or a cessation comes about 
gradually, accompanied by hickups yawning and occasional coughing, 
with an increased secretion from the bronchial mucous membrane. 

Although, the sufferer, often as he may have safely undergone an 
attack, fears, that he will not live through the next, yet in the 
disease itself lies a remedy to allay danger as soon as- it arises. 

Treatment. The indications for treatment of the disease itself are, 
first, to arrest, shorten or mitigate the fits ; and second to take meas- 
ures for the prevention of their recurrence. 

To attain the first object, before all else the patient must be freed 
from all tight clothing, and his appartment supplied with pure, dry, 
warm air. He must avoid feather pillows, substituting one of horse- 
hair. Further, towards evening he must avoid all physical and men- 
tal exertions. The evening meal must be an easy digestible one, 
and should be taken at least three hours before retiring. Special care 
must be exercised in the daily evacuation of the bowels. Around the 
neck, the patient should wear, loosely a light silk cloth, to protect the 
nerves from being chilled. Sufferers with Asthma will find great 
relief, to take a warm bath, just before retiring, at a degree of 95 
Fahrenheiclt, remaining in the water for half an hour. This has a 
soothing effect upon the nerves. If with all these cautions the 
attack comes anyway, place a piece of cloth saturate with oil of mus- 
tard, bottle No. 12, well covered with another greased piece of cloth 
over the outside of latter, over chest and neck, and give patient a very 
strong cup of black coffee made from about two ounces of roasted 
beans to the cup, let him drink as hot as possible. Rubbing the wrist 
chest and calves of leg with- turpentine, bottle No. 13, as well as foot- 
baths of hot water and salt, all have a tendency to ameliorate the fit 
and should be administered if the patient so desires it, and usually 
they do beg incessantly, that something more be done to alleviate 
their suffering, their feeling is bordering on to the agony of death, 
which, however, rarely occurs while in a fit. 

In order to avert future attacks, you should, first of all, caution the 
patient to avoid exposure to any irritants, which, according to his 
experience, have been the cause of previous fits. For instance, if the 
attack comes on whenever the patient sleeps in a dark or close room, 
he must always have a light burning, and leave his doors or even 



WHOOPING COUGH. 187 

windows open. All asthmatic persons, if they can possibly do so, 
should reside in a pure dry atmosphere, they should avoid dusty, 
smoky and windy localities, and should not sleep too long. 

Among all the reputable medicines for the prevention of new 
asthmatic fits, as well as for a radical cure, quinine stands at the head. 
The shorter and more regular the intervals of the attack, so much the 
more is to be expected from this drug. Therefore take for one or 
two weeks one Pill quiniae, 2 gr., Bottle No. 16, every morning and 
noon, and you will soon notice an improvement. Of course, you 
must be specially careful to have regularly a stool, at least once a day. 
If you find that your throat is especially dry, take, occasionally upon 
retiring, one pill Terpin Hydrat, 2 gr., Bottle No. 22. 

Whooping Cough, is a catarrh of the respiratory membrane, however, 
distinguishable from other catarrhs of this mucous membraue, both 
by its origin and by fits of spasmodic cough. 

Single cases of whooping cough are exceptional a proof that the 
specific cause of the malady, if it develop spontaneously, usually 
attacks many persons, and that, from a single individual the disease 
may spread to a great many. 

Epidemics of whooping cough occur most frequently during winter 
and spring, but do not die out upon the approach of warm weather. 
They often succeed epidemics of measles or of scarletina, and some- 
times accompany them. 

The contagion seems to lie mainly in the secretions and exhalations 
of the diseased mucous membrane. 

Predisposition to whooping cough is greatest in children, particu- 
larly in such as have attained their second year. It is an important 
iact that this predisposition is enhanced by any causes capable of pro- 
ducing catarrh, and still more so by the presence of any accidental 
irritation of the respiratory mucous membrane or from other causes. 
Colds, slight but neglected catarrhs, often furnish the exciting cause 
of an attack of whooping cough; also errors of diet. 

Predisposition to whooping cough always diminishes as age ad- 
vances and is extinguished almost without exception after one attack 
of the disease. 

Symptoms. As a usual thing three stages of whooping cough are 
recognized : The catarrhal stage, the convulsive stage and the stage 
of decline. 



188 SYMPTOMS. 

The first, or atarrhal stage, usually begins with violent catarrhal 
fever, with redening of the lids of the eye and great intolerance of 
light. The patient sneezes incessantly and is tormented by a distressing 
cough. No one without knowledge of the prevalence of an epidemic, 
coulci predict the approach of a whooping cough at this stage of its 
development. In a few days the fever abates, the redness of the lids 
of the eyes and the catarrh subsides. The cough, however becomes 
more obstinate and persistent and at the end of each spell an aston- 
ishing quantity of tenacious ropy, transparent mucus fills the mouth. 
This peculiar, adhesive, copious secretion is characteristic of whooping 
cough in its second stage and establishes the diagnosis almost with 
certainty even at this stage of the disease. Soon, however, the cough 
assumes a peculiar character; it is accompanied by violent relaxation 
of the muscles of the larynx, causing spasmodic closure of the glottis. 
From this point is dated tae beginning of the convulsive or whooping 
stage. 

The coughing fit begins with a long • drawn clear piping sound. 
Then follows a series of short, rapidly interrupted, expiratory coughs, 
and this in turn is succeeded by the crowing, long drawn inspiratory 
act. Thus the "whoop" alternates with the cough, the latter finally 
becomes inaudible until at last the ropy secretion is brought up and 
is removed intentively by the loving mother, or else, what is more 
frequent still, is ejected by vomiting, together with some of the con- 
tents of the stomach. The patient grows deep red or bluish, the 
face become swollen, the eyes shed tears, and seem as if about to 
burst from their sockets, the tongue looks thick and blue ; the little 
patient seems to be on the verge of suffocation. Bleeding from the 
nose and mouth and ears often takes place. Bleeding from the ear 
is caused by the rupture of the drawn skin. 

The vomiting, which in bad cases empties the stomach of all its 
contents whenever the child coughs, is not always the only indication 
of the forcible compression of the abdomen. Sometimes, not often, 
however, you will notice involuntary evacuations of the bowels and 
urinating; at others, rupture or prolapse of the rectum is produced. 

A sensation of tickling in the throat usually precedes each fit of 
coughing, the number of which, in the course of a day or night, may 
amount to twenty-four or upward. The children recognize these 
precursors of an attack with dread. They cling anxiously to their 
mothers, seek a support for their head or begin to cry. After the fit 



TREATMENT. 189 

they remain for a while exhausted and suffer from pain near the lower 
ribs. Soon, however, they recover, begin to play, or to eat with a 
good appetite, until a new fit interrupts their comfort. 

Every coughing spell is a source of irritation to the mucous mem- 
brane of the larynx. The more violent it has been the more rapidly 
does new secretion form and so much the sooner is the next fit to be 
expected. 

The convulsive stage having lasted three or four weeks, and in 
some cases that many months, the stage of decline gradually sets in. 
The catarrhal secretion loses its tenacious transparent quality, and 
becomes more liquid, yellow and opaque. The fits are no longer 
provoked by slight external irritants and the secretions become more 
easy of ejection; at last the fits come at longer intervals and are of a 
shorter duration. Vomiting also ceases, unless a coughing spell occurs 
again with its former violence. Relapses are very liable to occur if 
the child is not very carefully protected from all pernicious influences. 
The mucous membrane remains sensative for months even after the 
little child has recovered and the disease has become extinct. 

Whooping cough terminates in recovery in a very large majority of 
cases. According to popular belief, such an event cannot occur before 
the eighteenth or twentieth week, which is very dangerous to believe, 
inasmuch as it betrays many a mother into all sorts of heedlessness. 
Under careful treatment and systematic nursing, it is almost always 
possible to bring the disease to a favorable termination in from four to 
six weeks. 

In some isolated cases, the malady terminates in an incomplete 
recovery; by leaving all sorts of herina or rupture. Some of the 
children remain during their life short of breath. Of course if the 
little sufferer is not carefully looked after, the whooping chugh, al- 
though apparently cured, can yet develop into lung troubles, such as 
consumption and pneumonia. 

One must be aware how rarely children die in a whooping cough 
fit, before one can witness a fit without anxiety. Experience accord- 
ingly teaches, that the mothers, who at first are dreadfully alarmed, 
by and by only grow too careless, and at last without further solicitude 
or attention, calmly await the advent of the twentietht week, when, as 
they think, the disease is to subside. 

Treatment. As whooping cough scarcely ever occurs, except as an 
epidemic, and as it is often infectious, it is necessary to avoid spreading 



190 WHOOPING- COUGH. 

of the disease, where circumstances permit, an avoidance of places 
where the epidemic prevails, and the separation, of the sick from the 
well, particularly from those small, weak, scrofulous children,to whom 
the disease would bring great danger. 

The happy effect which whooping cough patients obtain by change 
of aDode is surprising and should be resorted to. 

Mild sweating is a good thing to cut the malady short. Very 
young children should not lie in a cradle, but should remain in bed 
alongside their mother or nurse, where they soon get into perspiration. 
The little patient should wear a woolen sock around the throat and 
wear flannel next to the skin upon the chest. 

Throughout the warm season of the year the patient may be kept in 
the open air, but should return to their room before the cool of the 
evening sets in. 

As a drink give carbonized water, either plain or with hot or cold 
milk. 

Eeduction of the number, severity and duration of the number of 
fits, is as important for the cure of whooping cough as is prohibition 
of loud talking in the treatment of obstinate hoarseness. 

For this purpose parents caanot be sufficiently urged to make the 
child cease from coughing as soon as possible, and, if necessary, even 
to inforce this harsh demand with steamness, as soon as the mucus 
accumulation has been discharged. A portion only of the coughing is 
involuntary. By an exercise of firmness, a child may withstand the 
remaining inclination to cough. The mother must never tire of 
warning, admonishing, and if need be, threatening, though no imme- 
diate benefit become apparent, even after lapse oidays; for this mental 
dietic must never tire of warning, admonisoing, and if need be, 
threatening, though no immediate benefit become apparent, even 
after lapse of days ; for this mental diet must be maintained for weeks 
and weeks. Of course, parents who are stupid or rude, or who cannot 
control themselves should never undertake this treatment. Adults 
and children of mature years are better able to resist the inclina- 
tion to cough, than youngsters, and parents should learn to discrim- 
inate. 

This mental treatment is materially aided, if as soon as the child 
perceives a fit to be coming on, or when the tickling in the larynx 
gives notice of its approach, by giving about a quarter teaspoonful of 
bi-carbonate of soda, bottle No. 4, in a little water. This will reduce 



CATARRHAL PNEUMONIA. 191 

the ropyness of the mucus, and the secretion collected about the epi- 
glottis is thus the more easy expelled, with which the fit usually ter- 
minates. 

The following mixture is a specific in whooping cough, but cannot 
be embodied in the chest, for the reason that it will not keep any 
length of time; it can be procured, however, at any respectable drug- 
store for a mere trifle. 

R Coccinellae, 12 grains; 

Potas. carb., 1 scruple; 

Aquae dist., 3 ounces; 

Syrup simple, 1 ounce. 

Mix and take a teaspoonful when tne attack threatens. The effect 
this mixture has in shortening the fits of coughing is surprising. This 
mixture should not be given as a matter of routine but only when 
there is a collection of mucus in the throat and when a fit is approach- 
ing. Parents will soon find if they administer as directed, and not 
otherwise, that it renders the attacks milder and shorter, and that it 
loosens the cough wonderfully. 

It is a well known fact that whooping cough must have its run, 
but in the latter stage of decline the little patient should be given a 
very nourishing diet, especially of nicely prepared meat, eggs and 
strong soups. 

Catarrhal pneumonia never arises unless preceded by bronchitis and 
solely through its extention of the morbid process from the bronchial 
mucous membrane into the air cells. This disease is mostly observed 
as a complication of measles and of whooping cough, and is mostly a 
disease of childhood during teething period and in very old age. 
Occasionally it is the cause of death. 

Symptoms. Is the inability of the air to penetrate the air cells of the 
lungs, wich causes quicknessin breathing and enlargement of the nostrils. 
The progress of this disease is sometimes, although not often a very acute 
one. The disease may prove fatal in a few days, especially if it attack 
small feeble children. In such an event the countenance, previously 
red, becomes pale and livid. The lips assume a bluish hue, the eyes 
grow dull and lustreless, and the restlessness gives place to indiffer- 
ence. Owing to the serious disturbance in respiration, the effect of 
incomplete oxygenation and over charge of the blood with carbonic 
acid soon m nif ests itself. It is very common for catarrhal pneumonia 
to take a chronic course. This is especially true of those cases which 



192 EXPANSION OF THE BRONCHIAL TUBES. 

let in upon whooping cough or chronic bronchitis. Here is a rule. 
Not only does the consolidation of the diseases form slowly and grad- 
ually, but it continues stationery with great persistency often for 
many weeks. The child becomes extremely emaciated, until death 
finally ensues with the symptoms given; or perhaps, after hope has 
almost ceased, complete recovery follows. 

Treatment. Approximately the same general treatment as in 
bronchitis should be given, except as to sweating, as by it too much 
strength is lost. The chest and back especially between shoulder blade 
should be thoroughly rubbed with oil of turpentine, Bottle No. 13. 
In severe cases the advice of the family physician should be taken, as 
he can diagnose complications more readily and give remedies for its 
speedy counteraction. 

Permanent Contraction and Expansion of the Bronchial Tubes are 
consequences of chronic inflammations. The inner walls of the air 
tubes, through it, loses much of their resisting power. Besides the 
pressure of the air in case of cough against the internal walls of the 
tubes, contribute greatly to the expansion. Contractions are of rare 
occurrences, they are caused by growing tissues and the contraction of 
same incident to the healing of sores. Under contraction, the tissues 
of the lungs suffer greatly owing to the obstruction to the penetration 
of air to all parts. 

Symptoms. The bronchial expansion grows slowly and may take 
years, before it is disagreeably noticed. The symptoms in the begin- 
ning are not accompanied by fever or loss of strength. It invariably 
causes a hacking cough, especially in the morning, after awakening, 
when the accumulated mucus attempts to free itself. This cough and 
morning expectoration lasts for some time, and the body is being 
freed from large quantities of sweetish, ill-tasting and bad smelling 
masses. The air tubes being widened, the .mucus can accumulate 
before becoming an obstruction, especially, so when one and the same 
position in bed is adhered to. When, then, upon arising, this ac- 
cumulated mass becomes shifted, coughing and expectoration ensu3s. 
If this putrid mass remains too long within the air tubes, it will dis- 
integrate, and is absorbed into the general system causing fever. 
While not a necessary dangerous disease in beginning, it will, how- 
ever, grow into consumption of the lungs if too long neglected. 

Treatment. The expectoration of the mass must be facilitated, 
through disinfecting vapors, which, at the same time have a tendency 



BLEEDING OF THE LUNGS. 193 

to lessen the mass and strengthening the mucous membrane. Take 
every morning, noon and at time of retiring, a pot of boiling water, 
which emits a good deal of steam in a small column, add to this 
twenty-five drops Oil of Turpentine, Bottle No. 13, and ten drops 
Carbolic Acid, 10% C. P., Bottle No. 5, and inhale the vapors. Do 
not force yourself to cough, but let these vaporse do the losening 
process. 

Bleeding from the air tubes and lungs or Haemorrhages comes 
from the capillaries, from which, through the action of coughing, it is 
expectorated with mucus. Bleeding from the lungs, etc., is always 
accompanied by a cough, and through it, you are pretty surely guided 
from whence the bleeding originated. In bleeding from the nose, if 
occurring at night, the patient also awakens with a cough and vomit- 
ing of blood, but soon ceases while the bleeding continues. 

Symptoms. The admixture of small quantities of blood in expector- 
ations of catarrhal character, occuring in the form of minute streaks 
traversing the mass. It is a very common and quite harmless symptom. 

The expectoration of a somewhat larger amount of blood, pure or 
mixed with mucus, which sometimes follows upon the inhalation of 
acrid vapors, or after a severe irritation of the passages, and in conse- 
quence of diseases of the heart, seldom results seriously, and rarely 
imperils the patient's life. 

Very profuse haemorrhages, of a different nature, often arises from 
the inability of the capillary walls to resist the pressure of the blood, 
and these bleedings are usually termed "spitting blood," or '-the 
bursting of a blood vessel." It is very seldom that these attacks are 
preceded by warning symptoms or by sensations of constrictions of 
the chest. The bleeding sets in suddenly. The patient feels as 
though a warm liquid were oozing from beneath his breast bone ; he 
perceives a strange sweetish taste in his mouth, and, upon attempt to 
clear his throat, finds that he expectorates blood. Such a discovery 
generally has a depressing effect, even upon individuals of the utmost 
courage. The bleeding may have been trifling, still the patient will 
feel tremulous, pale and almost fainting. Soon after raising the first 
blood a sense of irritation induces inclination to cough. Course, 
moist, rattling and gurgling sounds are audible in the chest; a short, 
full, loose cough follows, and, frothy, bright red blood gushes from 
the mouth and often from the nose. Short pauses intervene between 
the coughing fits, during which more blood seems to be escaping and 



194 TREATMENT. 

collecting in the tubes, and, in this manner, large quantities of it are 
often ejected in a short time. The quantity of blood thus lost, varies 
from one ounce to a pound and cften even more. The attack may 
subside in course of half an hour, sometimes sooner, at times not for 
several hours. Attacks of bleeding are rarely solitary, they frequently 
recur in the course of a few hours, or perhaps the next day, even, 
in spite of all treatment. After which, however, the patient usually 
obtains a respite from his bleeding, which may last for months or 
even years. Life is very rarely endangered from bleeding, but death 
often occurs from bronchial obstruction and the consequent impeded 
respiration. 

Persons, who have suffered severe haemorrhages from the lungs, 
even though it may not have followed by any ill effect, and may have 
recovered entirely, are, nevertheless in danger of dying, sooner or 
later of consumption. 

Treatment, The dangerous indication, above all things, demands a 
cautious course. In the first place, seek to calm the spirits of the 
patient, which are always much excited; and, inasmuch as these at- 
tacks are almost always repeated several times, it is well to save the 
patient from further agitation, by straightway informing him that 
there is more blood to come, while, at the same time, you should 
deny the possibility of bleeding to death. 

If the person, afflicted with this malady, is not in bed at the time of 
attack, he should be at once undressed, especially of all tight fitting 
clothes, and put to bed. The room should be light and comfortable, 
it must also be well ventilated and the utmost quite must be insisted 
upon. The position of the patient in bed should be the most 
comfortable, with back and head well propped. Do not overheat the 
chamber, but have it moderately cool; forbid all hot drinks and food. 
Interdict all conversation, and make the patient resist the provocation 
to cough. The most powerful means of combating the bleeding is the 
use of cold to be applied to the chest in the shape of cold compresses. 
In addition to this let the patient swallow small pieces of ice, or small 
doses of ice water. To check the bleeding, let the patient swallow 
one or two teaspoonfuls of finely powdered dry salt. 

The diet during this disease must be a light one, consisting only of 
soups and other non-exciting substances. Costiveness must be com- 
bated with injections of cold water, to which a little vinegar has been 
added. For stool or urinating, the patient should not get up, but be 



PNEUMONIA. 195 

served with a pan or bottle respectively. In case of strong palpitation 
of the heart, apply cold compresses, but only so long, as the cold is 
agreeable to the patient. 

Haemorrhages from the respiratory organs, being a forerunner of 
more serious diseases, it is always to be reeommended to call in the 
family physician. 

Pneumonia or Inflammation of the Lungs. The liability to pneumonia 
exists at all periods of life, down to extreme old age. It is rare 
however, among infants at the breast, and in the first years of child- 
hood. Males are attacked more frequently than female ; not, however, 
because vigorous, full-blooded persons are peculiar subject to the dis- 
ease. The latter, indeed, are by no means exempt, but feeble and 
broken down subjects, convalescents from grave diseases, individuals, 
who have already suffered from pneumonia, are perhaps more liable 
to be attacked than the robust; pneumonia often complicates diseases, 
which have already effected an impoverishment of the blood with 
emaciation and constitutional exhaustion. Its exciting causes are 
generally unknown and the opinion of great meclicial men are even 
divided as to the effect of cold in producing pneumonia. 

Symptoms. The commencement of pneumonia, in almost all cases 
is announced by a convulsive chill, or rigor, which may last for half 
an hour or even for several hours, before giving place to a sense of 
heat. The cold is a mere subjective symptom and the temperature 
is appreciably elevated, even during the chill. 

The chill is important in a diagnostic point of view. In no other 
affection, excepting intermittent fever, are chills of equal violence en- 
countered. The vigor of the chill, which ushers in pneumonia is almost 
always the only one throughout the entire course of the disease. It is 
from this chill, that the duration of the disease is counted. In chil- 
dren convulsions often occur instead of chills. 

The temperature rises to 103° or 105 ° Fahrenheit rarely higher, 
even on the first day, is accompanied by a quickened pulse, and by 
increase of thirst. The countenance is red, and the patient complains 
of pain in the back and loins, and of a distressing soreness of the 
limbs. There is great prostration and muscular debility. The 
tongue is coated, and the appetite entirely gone, occasionally there is 
vomiting. As these symptoms often precede the local manifestations 
by one or two days, they are attributed to the accumulation of fibrin 
in the blood. 



196 SYMPTOMS. 

Symptoms of functional disturbances appear in the lung either 
simultaneously with the chill, or immediately afterwards. The first 
of these is shortness of breath, a constant accompaniment of 
pneumonia. Assuming the normal rate of breathing of adults to be 
twelve, sixteen or twenty breaths per minute, you see it is augmented 
in pneumonia to forty and even to fifty breaths per minute. In chil- 
dren it even attains a still greater frequency. The length of each 
respiration is proportionately short, the breathing is superificial, a 
fresh inspiration is required during the enuciation of a short sentence, 
speech is interrupted. 

Pain is constant a symptom in pneumonia which is . absent in 
but very few instances. In most cases, but not in all, the patients 
assign the seat of the pain to the point at which the inflamed lung 
comes in contact with the thorax. In other cases it is felt at more 
remote points and even on the other side. Every deep inspiration, 
and especially every forcible expiration, such as accompanies coughing 
or sneezing, aggravates the suffering, as do also pressure apon the 
chest and movement of the muscles between the ribs. The character 
of the pain is usually described by the patient as piercing or stabbing. 
It rarely continues in all its violence for any length of time. It is 
one of the most burdensome symptoms at the commencement of the 
disease and afterwards diminishes or completely ceases. It is apt to 
be of exceedingly transitory character, or even to be altogether want- 
ing in the pneumonia of old persons and very feeble subjects, parti- 
cularly if the seat of the inflammation be the apex of the lungs or one 
of the upper lobes. 

Cough very soon associates itself with the fever, difficulty in breath- 
ing and pain in the side. It is at first short, ringing and harsh. The 
patient endeavors to repress it; they dread to cough, make painful 
distortions of the countenance while so doing. In almost all cases a 
peculiar spittle, characteristic of the disease, begins to be ejected at 
an early period. It almost always contains blood in small quantities. 
The pneumonia of old people alone forms an exception to this rule. 
At the commencement of the attack the pneumonia spittle are so 
tough and adhesive that it is difficult to remove them from the mouth, 
and they must be usually wiped away with a cloth. 

The pulse, whose frequence in pneumonia of average severity, 
ranges between 90 and 120 beats per minute, may, in severe cases 
where the temperature is very high, attain a frequence of 130 to 150 



SYMPTOMS. 197 

per minute. At the outset of the attack it is usually large and full, 
but as the malady progresses it becomes small and soft. 

The headache, by which the invasion of pneumonia is accompa- 
nied usually continues throughout the attack. It is usually accompa- 
nied by sleeplessness, or the sleep is troubled by dreams, and if the 
patient be the slightest bit of an irritable temperament, there is apt 
to be a delirium. 

The latter symptoms are due to the fever and subside with the 
latter. 

The appetite is usually lost, the tongue is lightly coated with white 
and shows a tendency to dryness, the thirst is considerably augmented 
and the stools are dry and constipated. 

The discharge of urine is increased and becomes turbid upon cool- 
ing. The patient looses considerable of his weight during the disease. 

In calculating the duration of the disease, it will be seen that the 
critical period of pneumonia takes place about the sixth day. The 
symptoms continue with constant or increasing intensity until the critical 
day. While the condition of the patient, from difficulty in breathing, 
thirst, and the intense constutional disorder, is beginning to awake 
an earnest solicitude, a striking change takes place, often within a few 
hours. The temperature and the frequence of the pulse often sink 
rapidly, the difficulty in breathing abates, and the patient feels easier 
and more free. In the course of twenty-four hours convalescence is 
often established. The patient sleeps, calls for food, and merely 
complains of his debility. From this time the recovery of many 
patients progress steadily. The blood disappears from the expector- 
ations, sometimes gradually, sometimes with suddenness. 

Death takes place during the disease if the patient is not properly 
cared for. It is an extreme dangerous disease to aged persons and to 
drunkards, owing to their intolerance of even moderate degrees of 
fever. The proportion of middle aged patients who succumb to the 
disease is but small. Complications of pneumonia with consumption, 
disease of the heart, Bright' s disease, cause fear of unfavorable 
termination. 

Treatment. After carefully studying the foregoing remarks, you 
cannot possibly be misled in recognizing this dreadful disease of 
pneumonia. Nearly everybody with the symptoms of this malady 
before them, will rush for the physician to make sure that everything 
is done to aleviate the suffering of the patient, and also to have that 



198 TREATMENT. 

solace, in case of fatai termination, that you have done everything in 
your power and means to allay the disease and to bring through it the 
afflicted one. This action of the relatives is entirely proper and com- 
mendable, but a word of advice will, it is hoped, be not amiss and 
that is in selecting your physician who is to treat the patient do select 
one who is notoriously opposed to the administration of much internal 
medicine. It is a fact that more patients suffering with pneumonia, 
have succumbed during the malady from the big quality of all sorts 
of drugs administered to them than from the disease itself. While 
refraining entirely from prescribing for the patient any medicines to 
be taken internally, we can recommend during stage of fever the ad- 
ministration of quiniae pills 2 gr., bottle No. 16, every two hours, 
which has a tendency to reduce the fever and the action of the heart. 
Other medicines ought not to be taken. The fact that if the disease 
is left to itself in a vigorous patient, if uncomplicated and of moderate 
intensity, it always ends in recovery, has not been generally known. 
Indeed it has been proved that unless warranted by special indications, 
and for which you had better engage a homeopathic physician, and 
for him to determine- Active interference has an unfavorable effect 
upon the course of pneumonia. 

From the application of cold compresses very favorable results have 
been obtained and should be applied as follows : Cover the chest of 
the patient and the affected side in particular with cloths which have 
been dipped in cold water and well wrung out. The compress must 
be repeated every few minutes. Unpleasant as this procedure is in 
almost all cases, even after a few hours the patient will preceive and 
feel material relief. The pain, shortness of breath and often the 
frequence of pulse is reduced. Sometimes the temperature goes down 
a whole degree. Many patients under this treatment retain this sur- 
prising condition of improvement throughtout the entire duration of 
the attack, so that their outward symptoms would hardly lead one to 
imagine the grave internal disorder. The relatives of the patient, too, 
who do not fail to preceive the improvement, readily assist in the 
treatment to which they usually show some opposition in the begin- 
ning. 

It is only in rare and aggravated cases that these cold applications 
afford no relief or even increases the distress of the sufferer so much 
that they refuse to keep it up. In such cases it is useless to insist 
upon the further application of cold. 



TREATMENT. 199 

It is but natural that sufferers with pneumonia must keep their bed, 
but should not be buried in feathers. A good mattress with a thin 
quilt and sheet and light woolen blankets for covering are the proper 
thing. Loin, back and head must be well supported by means of pil- 
lows. The night clothes of the patient must be of the lightest kind, 
for every incumberance of this character increases the labor of breath- 
ing. The room should have a very even temperature of about 64 ° or 
65 Fahrenheit. In a warmer room the fever has a tendency to in- 
crease, and if colder, it would increase the cough. It is of the utmost 
importance that the temperature remains even during day and night, 
at the degree indicated. The air should not be too dry, and it is well 
to have some water in flat pans in the room. It is in fact a good 
thing to place near the patient a pan with boiling hot water in which 
a few drops of carbolic acid 10% c. p., bottle No. 5, have been poured. 
It will help his breathing materially. The room in which the patient 
lies should not be scrubbed or mopped, as it would make the air too 
moist and cool. Dust must also be strictly avoided in the sick room, 
as the making of it will materially increase the coughing. If the 
floor gets too dusty take some old newspapers, tear them into shreds 
and soak them in water, wring them out and throw upon the floor or 
carpet, the dust will then by gently moving those paper scraps, settle 
upon same and can thus be removed from the room without discom- 
fort to the patient. 

The diet should be light but nourishing, barley and oatmeal gruel, 
strained lemonade, orange juice, bread toasted and boiled to a mush, 
seasoned with sugar and a little fruit juice, roasted apples and such 
like. In convalescence strong beef soups, very young flowl and tender 
steak with eggs softly poached, toast, milk, etc., are the proper regi- 
men. The stool, if costive must not be neglected for a longer time 
than twenty-four hours, and should be facilitated by injections of 
some warm water, with a dash of pure cider vinegar in same. 

Under all circumstances it is necessary to have a nurse or other 
kindly disposed person in the sick room day and night, as the disease 
is very treacherous, and you are not sure at any time that delirium 
will not set in. It is also possible that the patient will collapse at 
once from inactivity of the heart. As soon as you notice this give 
the patient at once, with a little sweetened water, 20 drops of Hoff- 
man's anodyne, bottle No. 25, and place a mustard plaster, heretofore 
described, over the heart, but not long enough to draw blisters. 



200 CONSUMPTION. 

For the amelioration of the headache in the beginning of the disease 
also to reduce fever in head, put cold compresses on forehead. 

To quench his thirst the patient may take small pieces of ice in 
his mouth. Of course, this also must be denied him if it increases 
the cough. 

Convalescence is rapid after the seventh or eighth day, but care 
must be taken against relapses. 

Pulmonary consumption tuberculosis. This disease is a gradually in- 
creasing inabtlity of the respiratory apparatus to perform its functions 
in the changes of gases. The deprivation of sufficient air in the body 
causes a slow starvation similar to the result of prolonged abstenation 
from food. 

According to the researches of the now celebrated Doctor Koch, of 
Berlin, Germany, the exciting cause of consumption is the tubercle 
bacillus, a minute vegetable organism which he discovered in the 
spittle of consumptive patients. These tubercles form an aggregation 
of morbid matter, and form a deposit in the lungs of consumptives. 
They are composed of a hard, grayish or yellowish translucent or 
opaque matter, which gradually softens and excites suppuration in the 
lungs. Pus forms, which is expectorated. "When the suppuration 
destroys the minute blood vessels bleeding from the lungs also takes 
place. The disease becomes very decided as the tubercle lodges in 
the lung and there propogates mischief, which sooner or later causes 
complete collapse of the whole bodv- Thus is tuberculosis, or con- 
sumption of the lungs, the respiratory organ is destroyed by disintre- 
gation and the poor sufferer looses the machinery in the body, so 
necessary for its existence in bringing to it the life giving oxygen in 
the air. 

The tendency to consumption is, in many cases, congenital. When 
this congenital tendency is due to the fact that the parents were con- 
sumptive at the time of begetting the offspring, it may properly be 
spoken of as inherited. It is not, however, the malady which causes 
the inheritance, but the weakness and vulnerability of constitution 
which had already laid the foundation of the consumption in the 
parents, or which had risen in them in consequence of that disease. 
The heriditary constitutional feebleness of the offspring may proceed 
from other disease of the parent than consumption. Parents afflicted 
by other exhaustary maladies, or who are ruined by debauchery, or 
who are far advanced in years, are quite as liable as consumptive 



SIGNS OF CONSUMPTION. 201 

parents to beget children, who come into the world with a predisposi- 
tion to consumption. 

Among the influences, by which a liability to consumption is ac- 
quired, or by which a congenital predisposition to it is aggravated, 
that of an insufficient diet stands first. Feeding a suckling baby with 
bread, pap, etc., instead of the mother's milk, may sow the seeds of 
the malady. When thus, a child is ill fed, it acquires a feeblness and 
susceptibility to disease identical with a scrofulous predisposition. 

Onanism, venereal excess, depressing or exciting mental influences, 
immoderate study and inconsolable grief, intemperance, folly in dress, 
tight lacing, sedentary habits, factory air, are also predisposing causes. 

In fact all debilitating diseases of the respiratory organs if not 
checked in proper time have a tendency to foster consumption, pre- 
eminently among these are : catching cold, catarrh, irritation of the 
mucous membrane and the presence of foreign substances in the air 
passages. 

It is the most frequent disease extant, and about one-seventh to 
one-fifth of all deaths, are attributed to it. 

During childhood consumption is of rare occurence, but towards the 
period of puberty, and still more so between the ages of twenty and 
thirty, the malady attains its greatest frequency, becoming rarer as 
life advances, without becoming quite unknown even in extreme old 
age. Males and females are equally liable. 

Physical signs of consumption. Inspection of the chest reveals the 
existence of a "habit" in many persons who suffer from consumption 
or who are threatened by it. This term "habit" is used to signify 
that a peculiar build of the body indicative of a want of proper nutri- 
tion and development, add which is found in persons, who have been 
subjected to debilitating influence capable of stunting the healthy 
growth of the system before their bodies have become fully developed. 
The bones of such persons are slender, their skin is thin, their cheeks 
have a delicate redness, the white of the eye is bluish, the tissues be- 
neath the skin contain but little fat. The muscles are ill developed, 
those of the neck allow the chest to sink, causing the neck to seem too 
long. The intercostal muscles (between ribs) permit the ribs to spread 
widely apart, the entire chest is flatter, narrow and longer than in a 
robust and muscular person. The shoulders are also apt to sink for- 
ward and the inner edges of the shoulder blade are tipped up like 
wings. That cold and catarrh can invade such person very easily is 



202 SYMPTOMS. 

plain, and these are in a majority of cases the seed for this dreadful 
disease. 

Symptoms. The indications in the early stages are often very 
obscure. The main symptoms are impaired digestion and assimilation, 
thirst, nausea, vomiting, more or less cough, chiefly in the morning, 
hoarseness or weakness of voice; irregular pain in chest, difficult 
breathing on slight exertion, debility, languor and palpitation, ac- 
celerated pulse, hightened temperature, night sweats and progressive 
emaciation. 

Cough is a prominent symptom. In the early stage it is dry, short 
and irritative, and most troublesome in the morning, or after exei- 
tion, the expectoration is usually small in quantity and consists of 
ropy mucus, this cough may continue for months without aggravation, 
or the appearance of any other symptom. In a more advanced stage, 
cough recurs during the day, and especially after slight exertion, 
being caused by the necessity for getting rid of the inflammatory 
product and disintregated lung tissue, which then begin to accumu- 
late. 

Bleeding from the lungs frequently, but not always occurs, it is a 
very suspicious spmpton, and often gives the patient the first inti- 
mation of danger; its occurrence either before or soon after the com- 
mencement of the cough, always renders consumption probable, 
especially if the patient has received no injury to the chest and has no 
disease of the heart. 

Increased frequency of respiration, in greater or less degree, occurs 
in all forms of consumption, and proceeds from a variety of causes. 
Moderate acceleration of the rate of breathing is not always accom- 
panied by that distressing sense of shortness of breath requiring con- 
tinual forced inspiration for its relief. Even patient far gone in the 
disease have no trouble in breathing, except when some transient 
increase of the destructive assimilation going on in the system de- 
mands an additional supply of air. While at rest, they are fully 
capable of supplying their blood with oxygen, and of eliminating the 
carbonic acid formed in the system, without any fatiguing exertion. 
On the other hand, the increased inspiratory frequency may be com- 
bined with a severe and persistent shortness of breath, which, of 
course, is liable to still further aggravation, and is one of the most 
burdensome systems of disease. 

The augmented frequence of the respiration and shortness of breath 



CONSUMPTION. 203 

of consumptives is due to a diminution of the breathing surface of the 
lung or to obstruction of the air passages by the attendant catarrh 
and chiefly to fever. When cavities have formed in the lungs, a 
peculiar form of expectoration appears, which is generally described 
as characteristic of consumption. Rounded, grayish masses are 
found in the spittoon, separated from one another,by a greater or less 
quantity of clear bronchial mucus. If the spittle is collected in a 
glass, you can see irregularly rounded lumps, having a ragged outline, 
sinking slowly to the bottom. These lumps are almost positive indi- 
cation that cavities exist in the lungs. 

Fever is one of the most constant symptoms of all forms of con- 
sumption. The temperature in the patient in the morning is about 
normal, but towards evening often rises to about 102 o F. 

Emaciation and deterioration of the blood, the symptom to which 
consumption owes its name, properly succeed that of fever since there 
can be no doubt that it is to fever that they are mainly due. 

Any doubts arising as to whether consumption exists, after perusing 
these symptoms, must be explained by a physical diagnosis, but that 
belongs to the family practitioner, when he determines the health 
of the lungs by ausculation. 

There would be nothing gained to describe in this work the differ- 
ent stages a patient has to pass through if afflicted with consumption. 
Deat is the most frequent result and the sole termination of tubercu- 
losis. The fatal termination usually takes place through gradual 
wasteing away. The emaciation of the patient finally becomes ex- 
treme. The skin seems too loose for the body, owiug to disappearance 
of fat and wastage of muscles. The zygomantic bones project from 
cheek, the nose seem longer and more pointed, the orbits, from which 
all fat has disappeared, seem too large for the eyes, the nails become 
incurved, the pat of fat upon the last plalanges being gone. Frequent- 
ly the temper of the patient which at first was sullen and perverse, 
now grows cheerful and kindly. Many have perfect confidence in 
their recovery up to the moment of death, and expire with plans 
looking far into the future. Towards the last the suffering is often 
severe. 

Treatment. Prevention against consumption requies in the first 
place, that when a person shows signs of defective nutrition and a 
feeble constitution, especially if already he has given positive evidence 
of unusual delicacy, he should be placed, if possible, under influences 



204 TREATMENT. 

calculated to invigorate the constitution, and to extinguish such- 
morbid tendency. 

Delicate children, such as are born of consumptive parents, or 
which are otherwise decrepit, should not be suckled by their own 
mothers, still less ought they be brought up artificially on <s pap," but 
should be confided to a healthy wet nurse. 

After weaning the child, let its diet consist almost exclusively of 
milk instead of the customary soups of meal or bread and after it has 
done teething let it eat a little meat. This diet must be kept up 
during the whole period of childhood, whenever there is any skin 
eruption or scrofulous affection. Parents should not feed their little 
children with immoderate quantities of bread and potatoes. 

A proper supply of fresh air is of equal importance with regulation 
of diet. The baneful effect of continued indoor life in producing 
scrofula and consumption are not sufficiently taken into account by 
most parents. They very often suffer delicate, sickly children to sit 
day after day, and for hours at a time upon the benches of a crowded 
school room, after which they have their tasks at home to prepare, 
private lessons to take, the piano to play and all such stuff. Cod 
liver oil cannot possibly repair the injurious effects of such mode of 
life. As soon as this immediate schooling begins to tell, a total ceces- 
sation of it, should be the rule. 

In adults, when the signs of delicacy and weakness combined with 
deterioration of blood appear, the use of a little tincture of iron 
should be tried. 

Persons in whom a tendency of consumption is suspected should 
not inhale an atmosphere charged with smoke or dust, or which is 
too hot or too cold, as well as to make great efforts in running, sing- 
ing, dancing or to drink hot or alcoholic beverages. Chilling of the 
skin is to be guarded against and the patient should wear flannel 
next to the skm. 

Whenever there is the slightest suspicion of a predisposition to 
consumption, every catarrh, no matter how slight, is to be treated 
with the utmost care, which is not to be relaxed until the catarrh is 
entirely well. This rule is frequently not followed, and many people 
fall a victim to the deeply rooted prejudice that a neglected catarrh 
never leads to consumption. 

Climatic changes have a tendency to prolong the life of a consump- 
tive. 



CONSUMPTION. 205 

In the advanced stages of consumption it is but natural that you 
call in the family physician who can alleviate the suffering of the 
patient, even if he cannot cure. 

The diet of the patient should be an extremely nourishing one and 
milk as it comes from the cow cannot be too highly recommended in 
quantities as large as the patient can take it. Fat meat, strong conden- 
soups, and cod liver oil is also highly commendable. Trommers 
extract of rralt (non-alcoholic) is also a good tonic. Broth of rye 
meal, or cracked wheat with cream or milk. Soup of peas or beans, 
and chocolate are all proper dietary substances for consumptives. In 
case of night sweats the patient may drink a cup of cold sage tea. 

Such little results are evidenced from all medicines, we refrain from 
prescribing any, and leave it to the attending physician, to do for the 
patient what he can. 

In order, however, to ameliorate somewhat the suffering of the 
patient, a few hygiene rules will not be out of place. See that you 
have pure dry air in sick room, not too hot and not too cold, have 
spittons daily cleaned and keep disinfectants in some, also the night 
vessels. Change bed clothes every other day, or even daily if necessary, 
have the bed well shaken up and aired, so that it is perfectly sweet. 
Night clothes partake usually of the night sweats and should be 
changed daily. Be cheerful around your patient, even if you have to 
force yourself, and make the few remaining hours of your sufferer as 
bright as possible. 

"When the lung or part of it is gone and is not any more a part of 
the human organism, no physician can replace it, but as we use in 
our respiration only one seventh of the lung, by arresting the decay, 
and, through the physician's manipulation and the nurse's care, life 
can be indefinitely prolonged and made pleasant, even in cases, which 
seem hopeless. 

Great strides towards finding out the nature of this arch disease 
and the proper remedy, have been made of late by Dr. Koch of Berlin, 
and it is to be hoped that he will succeed in demonstrating, and pro- 
duce a remedy, by means of which, consumption of the lungs can be 
successfully cured. Surely the prayers of the world are with this 
great scientist, and it will not be long before we all may know of his 
success or failure. So much is evident, however, that he has found a 
remedy, "Lymph," which works wonders in insipieut consumption, 
but whether it is a lasting cure, only the future will reveal. 



206 PLEUKISY. 

Pleurisy is an inflammation of the membrane — the pleura — which 
surrounds the lungs and forms the inside lining of the chest. 

It may be caused by different things, but most prominent are: 
injury to the ribs and pleura, the entrance into the latter of foreign 
bodies, such as pus, blood, incidents to wounds, etc., it arises also 
through propagation of inflammation from neighboring organs, as 
from the lungs, abraisions of the ribs and intercostal muscles. 
Pleurisy, however, is oftener caused in consequence of exposure to 
cold, or to the action of other atmospheric influences, of which we 
have no definite knowledge. In the latter case it is usually termed 
rheumatic pleurisy. 

Symptoms. Pleurisy is not always easy to distinguish from 
pneumonia, the following are the chief points, however, which show 
the difference : Pleurisy scarcely ever begins with a single violent 
chill, while in pneumonia this is the rule. The course of pleurisy is 
never so roundabout, nor is there that sudden and complete change 
for the better, or crisis, which is always noticeable in pneumonia. 
In pleurisy the spittle is indicative of catarrh and some times con- 
tain streaks of blood; but there is never that peculiar, tough expector- 
ation, stained yellow or yellowish red, by intimate admixtures of 
blood, which is characteristic of pneumonia. 

Inflammation of the pleura is mostly on one side only and mainly 
on the left side. It manifests itself through heavy pain in the afflicted 
side and cough without expectoration. It never is without chills and 
fever, the latter, however, net of a high degree. As long as the pains 
in the side are extreme, the patient usually lies upon the other one, 
but as soon as they let up, the patient involuntarily reverses matters, 
in order to give his healthy lung all freedom in respiration. 

Pleurisy is a treacherous disease and must be closely watched, and 
in case the patient receives good care, the death rate from this disease 
is not a great one. 

Treatment. Sweating the patient is positively injurious and should 
not be resorted to under any circumstances. Give every two hours 
one quiniae pill, 2 gr., Bottle No. 16, and apply to chest, where pain 
is located, cold compresses, same as prescribed in pneumonia. If this does 
not afford material relief within five or six hours, it shows that more 
energetic treatment must be resorted to. The application of large, 
hot poultices made of cornmeal, linseedmeal, or hops do very good 
service, but these poultices should not be too thick and heavy, as they 
would weigh down the patient too much. 



ENLARGEMENT OF THE HEART. 207 

When detected iu its insipieucy a good- sized large mustard plaster 
often will knock pleurisy endwise, the application of which will also 
do instead of the hot poultices mentioned. 

Hydrothorax, Dropsy of the pleura or ivater on the chest, is one of the 
most formidable diseases, is never, however, an independent or 
primary affection, but is always secondary, being the result of some 
morbid process, which has given rise to the conditions necessary for 
the production of dropsy. 

Symjrtoms. Severe shortness of breath, aggravated by the slightest 
of exertions, and which compels the patient to sit upright in bed, 
suddenly startling in terror from sleep, swelling of the joints and 
eyelids. Inspection further reveals a dilation of the chest in the 
parts where water has settled. 

Treatment. Whereas this disease is usually the beginning of the 
end, and usually little benefit can be attained, success in cure is a 
rare occurrence. When the shortness of breath is intense, by the 
water pressing -against the lungs, tapping must be resorted to, but 
this, of course, must be done by a surgeon. The benefit temporarily 
obtained under such treatment is often very marked. It has at least 
a tendency to prolong life and make the remaining days bearable. 

DISEASES OF THE CIRCULATORY ORGANS. 

Enlargement of the Heart, in size and form, consists in the expansion, 
of ventricles and auricles, also in enlargement of the walls or heart 
muscles. These enlargements are caused in disturbances of the 
nutriment to the heartmuscies or disturbances of the circulation. Is, 
for instance, the blood from the right heart, insufficiently propelled 
through the lungs, into the left heart, then the former becomes con- 
gested, and through this engorgement the walls become dilated and 
the ventricle enlarged in consequence. Thickening of the walls shows 
that the heart tries its utmost to rid itself of this engorgement, in 
course of which extra labor the muscles of the heart become enlarged, 
in the same way as in muscular exercise of the arm of legs. Finally, 
however, it must come to a collapse, when the heart cannot stand the 
gradually increasing strain. 

Symptoms. Anxiety, shortness of breath, palpitation of the heart, 
pain in the heart region, weak pulse, enlarged veins, skin assumes a 
bluish hue, dropsical swellings, decrease in urine, attacks of dizziness 
and swoons are all symptomatic of this disease. 



208 PALPITATION OF THE HEAET. 

This disease will develope easily in the healthy subject and can be 
produced and fostered by many causes, such as dancing in tight fit- 
ting dresses, extraordinary mental or bodily excitement and the use 
and abuse of alcoholic beverages in all forms. There is perhaps not 
one habitual drinker in the world, who can lay claim to a healthy 
heart. 

Treatment. As soon as any of the above mentioned symptoms be- 
come apparent perfect rest is necessary, till a proper equilibrium in 
the circulation is established again. In bad cases, especially in case 
of emotional excitement, give 20 to 25 drops of Hoffman's Anodyne, 
Bottle, No. 25. Do under no circumstances, however, apply any 
irritants, such as mustard plaster to the heart region, as it will only 
increase the danger. 

When complicated with general nervous excitement apply to heart 
region, cold compresses. Of course, it is self-saying that the use of 
all mental and physical labor or excitement must cease for the time 
being, and also all alcoholic drinks (being included) tea, coffee, spices 
and strong food must for a while, also, be eliminated from the dietary 
list. 

Valvular troubles of the heart, and contraction of the arteries, are 
precarious diseases, and can only be ameliorated by a correct life, 
both as to occupation and diet. 

Parents cannot be too careful in watching their boys and girls, when 
about reaching puberty, in their mode of life. Through excess in 
mental or physical excitement, in boys especially the smoking of 
cigarettes and other forms of tobacco, has a tendency to lay a found- 
ation to the various diseases of the heart. Girls should not be allow- 
ed to lace too tight and not dance through the night. It will lead to 
numerous diseases, and especially the functions of the heart become 
much impaired. 

Palpitation of the heart, is only too often considered a simple nervous 
attack, but often this gets to be chronic and a family physician should 
be called in for an examination of the organ, whether it is an organic 
heart disease or of a temporary nature, if the latter, and when born 
out by the following symptoms, no danger need be anticipated. 

Symptoms. The nervous palpitation and nervous pain about the 
heart, commonly known as cramps of the heart, often happen of 
shorter or longer duration, while at the intermissions of pain or 
agitation not a raemHance of diseass seems to exists. 

/ 



TREATMENT. 209> 

In the attack the patient displays anxiety, and images as if the heart 
had ceased to perform its functions. It is irregular in its beat, the 
arteries in forehead and neck are filled nearly to burst. The breath- 
ing is dffncult, the patient sighs or gaps ; pain is intense. The patient 
must set up, perceives dizziness, swoon, roaring in ears, flickering 
before the eyes. All these symptoms come quite certainly and leave 
off likewise without leaving any marks, excepting that the patient 
fears a return of the attack. 

The cause of this kind of heart trouble lays mostly in disturbances 
in the digestive organs, trouble in the menses and errors in diet. 

Treatment. Give at once a thorough injection of lukewarm water, 
adding to it a cupful of pure cider vinegar, if the cause is digestive 
trouble or error in diet. If obstructed menses is the cause, let the 
young girl or woman sit upon a cane bottom chair, or w x hat is still 
better a seat similar to a water closet, of course her body where she 
sits must be bared, and put under the seat a vessel with very hot 
water so that the steam has free access to her private parts. At night 
in both cases, the patient should take one pill, comp. cathartic vegeta- 
ble, bottle No. 17. 

Young men or women troubled with this palpitation, must live a 
very regular life, abstain from all mental and physical excitement, 
especially dancing. They must leave off coffee, tea, chocolate and all 
alcoholic drinks and the boys must stop the use of tobacco in any 
shape. 

In case of attack see that the room is well ventilated; loose clothes, 
and upright posture for the patient are also desirable. Allow the 
patient small pieces of ice or little swallows of cold water and apply 
cold compresses to heart. 

Fatty degeneration of the heart is exclusively a disease of a glutton 
or drinker, and no person need to have this dangerous disease if they 
will eat moderately and leave all alcoholic and malt liquors alone. 
There is no cure for it, when once contracted, hence it is hoped that 
the advice here given about strong drink is heeded in time. 

This disease will last for years, and nothing can amelorate the 
pain and pangs of the sufferer, and terminates usually in apoplexy or 
rupture of the heart. Surely all the whisky in the world is not worth 
one broken heart, but how many are sacrificed to this poison every 
year, both directly and indirectly? 

Pericarditis or inflammation of the Pericardium is usually an extension, 



210 ANEUEISM. 

of inflammation from the pleura, or do to rheumatism of the chest- 
It hardly ever attacks a person in good health or appears as a solitary 
or indepent diaease. 

Symptoms. Pain and palpitation are the usual signs. The former 
effects usually the left side of the epigastrium. Excessive pain almost 
always signifies implication of ths pleura or lung in the inflammation. 
Palpitation is generally met with where the action of the heart is em- 
barrassed, and where the organ has difficulty in fulfilling its task. 

With regard to its course and termination, the forms of the disease 
which accompany pneumonia, pleurisy and acute articular rheuma- 
tism generally have a favorable issue ; the disease is acute and ends in 
complete recovery. It is only fatal when complicated with other 
diseases. 

Treatment. Same as in pleurisy, except as to quiniae, which must be 
omitted. 

Aneurism, or widening of the aorta, is a partial dilatation of this 
bloodvessel, caused by degeneration of its walls and is the only known 
disease occurring in this artery. 

This disease is very rare in young people. It occurs chiefly in 
somewhat advanced age, especially those who are subject to chronic 
inflammations. Men are much more frequently attacked than women, 
but as the majority of aneurism are found in persons who habitually 
make violent muscular efforts, this difference may be accounted for by 
the differences in the occupation of the sexes. 

Symptoms. Persons suffering from the disease often perish sudde nly 
and unexpectedly of internal haemorrhages, before the malady has 
given rise to any great degree of distress. At other times the symp- 
toms are so obscure as to render a positive diagnosis impossible. The 
widening may be in any part of the aorta, and it is hard to determine, 
for a layman, where the disease is located. The physician should be 
called in to administer such remedies as may be deemed best to him 
and his directions should be followed. "When the doctor has recog- 
nized the existence of the disease you must see to it that the patient 
lives moderately, feeding him on a meat diet. 

Congestion of the veins are of a common occurrence, and to it belongs 
the painful piles heretofore described. The most disagreeable form of 
this disease is the varicose vein of the calf of the leg, which often ha v e 
a tendency to rupture. In such case the patient must be placed in 
bed at once and the afflicted leg be elevated by means of suspension. 



CONGESTION OF THE VEINS. 211 

While in this position wash the leg thoroughly in lukewarm water, 
(pint) to which two teaspoonfuls of carbolic acid 10% c. p., bottle No. 
5, has been added. After this has been done take some cotton wad- 
ding and saturate it in carbolic acid 10% c. p., bottle No. 5, taking 
one-third of the acid and two-thirds water, and place this wadding 
upon the wound* Then wrap the whole lower leg in a bandage, com- 
mencing at the toes and tie the bandage below the knee. This will 
stop the bleeding, but the leg must be elevated for two or three days 
and after that the patient must remain quiet in bed for a few days 
more to insure complete cecession of bleeding and healing of the 
wounds. People afflicted with enlarged or varicose veins should 
habitually wear an elastic stocking on the leg where the veins are 
enlarged and wash this member daily with alum, bottle No. 1, 
dissolved in water, (one teaspoonful to a cup.) 



Diseases of the 
Urinary and Sexual Organs. 

KIDNEYS. 

TS) IDNEYS. Bleeding from the kidneys is usually caused by wounds, 
p\ contusions and other injuries to the organs; also from rush of 
blood to thern, or from concretions in the basin of the kidneys. 
Symptoms. The occurrence of the kidneys bleeding does not become 
recognizable, unless the blood is discharged with the urine. 

The course af these haemorrhages necessarily depends upon the 
nature of the disease, which causes it, when induced by concretions, 
bleeding occurs regularly after every violent exertion. Bleeding is 
usually accompanied by chill, pain in loins, and vomiting. 

Treatment, If only slight, rest is all that is necessary, when how- 
ever the bleeding is persistent, place a bladder filled with ice or ice 
water on back in the region of the kidneys. 

Brights disease or inflammation of the hidnegs is known in two forms, 
acute and chronic. 

In the acute form, it is frequently a complication of scarlet fever, it 
also arises in typhoid, measles and the poison of malaria. 

Symptoms. In the acute form it commences with a chill, followed 
by fever and sharp pain in the region of the kidneys. In addition to 
this, there is almost always more or less of violent vomiting and 
parents should watch with solicitude, the last named symptom in 
children with scarlet fever, and seek medical aid at once. The patient 
feels a constant inclination to pass water, but is unable to pass more 
than a few drops at each effort. The suppression of urine may be 
so complete, that the whole amount secreted in the covrse of a day 
may not exceed an ounce or two. Sometimes, and for a short time it 



BRIGHT' S DISEASE. 213 

may be of the color of pure blood, more frequently it is opaque, and 
of a peculiar dirty reddish brown hue, and looks as if it really con- 
tained dirt. Both urine and sediment have this dirty appearance, and 
is a tolerably sure sign of acute Bright' s disease. There is a very 
large quantity of albumen in the urine, which of course must be 
determined by a medical man. Dropsical symptoms set in, which 
soon become severe. The face, hands, legs and testicles swell up and 
the skin is so tensely swollen, that an impression made upon it by 
the finger is soon effaced. When the progress of the disease is favor- 
able, the urine becomes free and more abundant, at the same time 
there is an abatement of the droysy. In the most fortunate cases, the 
disease may terminate in from eight to fourteen days, recovery being 
complete and leaves no other diseases in its tracks. Is the disease, 
however complicated with inflammation of the lungs, pleura, peri- 
cardium, etc., the patieut usually succumbs. 

Treatment. Warm baths, followed by envelopment of the body in 
warm blankets, is the best remedy. Care must be taken however, 
that the bowels are kept open , by means af injections of lukewarm 
water. Diet nearly an exclusive one of milk and eggs. As drink give 
carbonated water, not too cold, such as soda or seltzer water. During 
convalescence, give minute doses of quiniae, 1 gr., bottle No. 16, 
(small size of pill). It is advisable to consult a physician in very 
acute and complicated cases. 

Chronic Blight's disease is one of the most treacherous diseases extant. 
The tubules which clarify the blood and take from it the urine and its 
constituent parts become inflammed, its cells first increase considerable 
in bulk, becoming fatty granules, which become loosened and pass 
into the urinary tubules. Through this inflammation the kidneys 
undergo gradual wasting away. 

Bright's disease (chronic) is a very common one. Predisposition to 
it is far less in childhood, than in more advanced life. Men are 
attacked by it more than women; and debilitated persons more than 
the robust ones. 

Its chief causes are exposure to cold and moisture, the misuse of 
medicines working specially upon the urinary organ. However, of all 
predisposing causes, is not only the abuse, but also the use of alcoholic, 
vinous and malt liquors. Bright's disease occurs as frequently in 
hard drinkers as measles in children. 

Symptoms. Neither pain in the region of the kidney nor any 



214 CATARRH OF THE BLADDER. 

unusual flow of urine, calls attention to the grave disease, which is 
developing, yet its recognition is not difficulty for the better class of 
physicians recognize it in the urine. Many patients are not aware of 
this terrible malady till dropsical signs make their appearance. As 
soon, however, as a person notices a failure of the strength, and a 
pallor and bloodless skin, he should consult a good physician with a 
view to have his urine examined. Does the doctor, then find albumen 
in the urine, it is conclusive evidence of the existence of Bright's 
disease. The existence of albumen in the urine becomes apparent 
long before the dropsical symptoms set in. 

Treatment. As long as the layman is unable to diagnose this 
disease and needs the physician anyway, his directions as to treat- 
ment should be strictly followed. 

Cancer of the kidneys is beyond healing and all you can do is to nurse 
the patient and make his remaining days as easy as possible. 

Catarrh of the bladder arises from direct irritation of its mucous 
membrane, unskillful injections in gonorrhoea, stone in the bladder, 
etc., also from inflammation of surrounding glands. 

Symptoms. Acute catarrh of the bladder is sometimes accompanied 
by fever, but not often. Patients complain of an undefined pain in 
the region of the bladder and extending to the urethra. Pressure 
exercised in the endeavor to urinate gives pain. The collection of a 
few drops of urine in the bladder occasions the most urgent desire to 
get rid of it. The patient hardly has the urinal out of his hand, and 
the few drops which he succeeded in expelling produce a feeling as 
though molten lead was running through the penis. As in all acute 
catarrh, at first the quantity of mucus formed is small, so that but 
few flocks are in the urine. By and by the urine becomes turbid and. 
a regular sediment follows in the vessel. The disease may run its 
course and get well in a few days, and that caused from drinking new 
beer passes off in a day or so. If not looked after it become chronic, 
in which form it becomes a veay dangerous disease, especially to old 
persons. In cases of long standing ulceration of the mucous mem- 
brane of the bladder is liable to set in, especially when the sediment 
in the urine grows more purutent. 

When cattarrhal ulceration and inflammation sets in, the patient 
becomes collapsed, his countenance appears sunken, pulse weak and 
the skin cold. The urine is discolored, of a brownish or blackish hue, 
contains shreds of mucous membrane, and smelJs badly. It is then 



BED WETTING. 215 

liable to grow into periotonitis, from which the patient usually dies in 
a few days. 

Treatment. In acute cases apply to abdomen hot poultices and 
warm baths, do not use any salt and spices and drink nothing but 
the purest water and milk. Soda water without sweetening or flavor- 
ing extract is a good thing. 

In chronic cases a physician will have to use artificial means to 
relieve the patient of the accumulation of urine by means of a catheter, 
and at the same time he will prescribe such pallatives as may be 
needed. 

Stones in the bladder vary in size, shape and chemical composition. 
The smaller ones are usually termed* 'gravel." Their origin is obscure 

Symptoms. Sometimes, but not often, patients with stone in the 
bladder have a distinct perception that there is a foreign body in 
their bladder, which changes its place as the posture of the patient is 
altered. A more important and constant symptom is pain about the 
bladder, which is aggravated by walking, driving, or riding,and which 
is relieved by laying on the back. The pain darts along the penis. 
During urination the stream is often suddenly interrupted, owing to 
obstruction in the neck of the bladder by the stone. If the patient 
changes his attitude the ability to pass water is frequently restored. 
Especially towards the end of urinating the pain is acute and is com- 
bined with pain in the testicles, thighs and loins and spasmodic con- 
traction of the anus. 

Treatment. Take of bi-carbonate of soda, bottle No. 4, two tea- 
spoonfuls and dissolve in a tumblerful of pure rain water, and take of 
it a tablespoonful every hour. If this remedy, which has a tendency 
to dissolve the stone in the bladder, fails after trying it for a week or 
ten days, our advice is to have an operation performed by some relia- 
ble surgeon, which now-a-days is quite void of danger. 

Bed wetting. A frequent and troublesome affection of children and 
is a partial or complete loss of power to retain the urine. The trouble 
is most frequent between the ages of two and sixteen years, and this 
involuntary emission of urine usually occurs at night during sleep. 
The causes are worms in the intestines, scrofulous affections, bad 
digestion, too much warm fluid at supper, strong spices, gravel or 
stone in bladder and general debility. 

Treatment. Avoid, as much as possible, the causes, and give a 
small pinch of bi-carbonate of soda, bottle No. 4, in a little water, 



216 GONOKKHOEA. 

three times a day, until the bladder is stimulated. All salt, sharp and 
sour articles of food, malt liquors, as well as alcoholic beverages, tea, 
coffee, etc., must be avoided. Eat nourishing food but do not allow 
too much drink. Plain water, milk and cocoa are suitable beverages. 
Mothers should coax the child to empty its bladder before retiring, and 
should arouse once or twice the little one during the night, with a 
view to having them urinate. Children thus affected should sleep on 
a hard mattress with light covering. They should never lie on the 
back. In aggravated cases let the child take a warm bath just before 
retiring, but see to it that the child is well rubbed down, especially on 
back and abdomen. Let the children thus affected take much out- 
door exercise of a gentle nature. 

Corporal punishment aggravates the disease by weakening the 
nerves. Parents who resort to this mode of trying to eflect a cure, 
will sooner or later find out what mischief they have done. Beware! ! 

Gonorrhoea or clap is a violent catarrh of the male urethra. It is a 
specific disease. Its course distinguishes it plainly from all other 
catarrhs which effect the urethral mucous membrane, or that of other 
parts. The difference is all the more decided for gonorrhoea never 
arises otherwise than by contagion, in spite of the denial of some 
sentimentalists, and the lying assertions of shame faced patients. 

Little is known about the viris of gonorrhoea, only that it always 
will produce a clap, never a chancre of syphilitic disorder, with which 
the former has nothing in common. The gonorrhoeal viris is a fixed 
contagious matter, and its vehicle is the secretion of the diseased 
mucous membrane, and it is only by contact of this secretion with a 
mucous membrane susceptible of infection that the complaint can be 
transmitted from one person to another, or from the mucous mem- 
brane of one organ to that of another in the same individual. Thus a 
person afflicted with gonorrhoea, and handling his penis, 
getting some of the viris on his fingers, and then rubbing his eyes, 
can very easily contract gonorrhoea of the eyes by transmissisn. 

As in all other infectious disorders, between the time of infection 
and that of the outbreak of the disease there is a certain interval 
known as the period of incubation, which varies from three to eight 
days. Contact of a mucous membrane with gonorrhoeal viris does 
not always result in infection, and varies greatly in different individ- 
uals. 

Symptoms. The commencement of a clap is announced by an itch- 
ing sensation at the mouth of the urethra, which does not amount to 



SYMPTOMS. 217 

pain, accompanied by a scanty secretion of a transparent, clear mucus. 
At the same time the opening is slightly reddened and the lips around 
same are usually agglutinated by the dried secretion, a thin scale of 
which is also spread over the hips of the glands. An increased desire 
to pass water sets in; the patients often have during night, emissions 
of semen, and during the day suffer from frequent erections, which 
often induce thoughtless persons to indulge in sexual intercourse. 
Gradually, in the course of a day or two, the sense of itching in the 
urethra gives place to a burning sensation extending along the entire 
urethra as far as the neck of the penis. The pain increase and dur- 
ing the process of urinating is usually of intense severity. The in- 
clination to pass water becomes more frequent than before, so that 
with each effort a few drops only are expelled and these with the 
utmost suffering. The secretion formerly scanty, tenacious and 
transparent, gradually becomes more copious, thicker and purulent, 
making yellow, stiff stains upon the patient's linen. The lips of the 
opening of the penis are red and swollen, as well as the entire penis, 
especially the head, and the urethra throughout its entire length is 
sensation to pressure. At this period the foreskin, irritated by the 
discharge, often becomes excoriated and swollen as if dropsy had 
settled between its layers. When the foreskin is in such condition it 
is very dangerous to try to pull it back. At this stage erections occur 
at greater frequence than at the outset of the disease and the stretch- 
ing and expansion which the organ undergoes during the process, 
causes the most intense pain to the patient, deprives him of his rest at 
night and induces him to resort to the mildest expedients to arrest his 
suffering. These symptoms usually continue to increase for a week 
or two. After attaining their acme, the pain when urinating begins to 
abate, the redness and swelling gradually subside, erections are less 
frequent and less painful, but the discharge is more profuse than ever, 
which is regarded, erroneously, however, by a great many as a favor- 
able sign, and think that the clap must run its course. After a lapse 
of one or two weeks more, the discharge gradually diminishes, becomes 
mucus and may finally cease altogether in the course of five or six 
weeks without any treatment whatever. Much more frequently, how- 
ever, there remains a scanty stationery discharge of mucus, which 
may last for months; yes, even years. 

During the day, if the intervals between the acts of urinating be 
long, this secretion glues the lips of the urethra together. When the 
patient awakens in the morning, a large drop of it has collected 



218 TREATMENT. 

and runs out between the adherent lips of the opening of the penis, 
as soon as they are separated. The stiff stains upon the shirt or bed 
clothes are now of a more grayish color, although generally there is a 
small but distinct yellow spot in their middle. A discharge of this 
kind is called " Gleet." If the patient exposes himself to further ex- 
citing cause, while this gleet lasts, the gonorrhoea frequently breaks 
out again; that is, the pain does not return, but the discharge once 
more becomes abundant and more purulent. Excess in wine, liquor, 
beer, strong coffee or tea, or sexual intercourse, is the most apt to 
cause such relapses, but exposure to cold and overexertions seem to 
have a similar effect. The symptoms and course of gonorrhoea pre- 
sent a good deal of variation as to the degree and duration of the in- 
flammation, pain, redness and swelling of the mucous membrane. 

The* flexion, which the penis undergoes during erection in this 
disease, and commonly known as chordee, demands a few words of 
consideration. These flexions result from a loss of elasticity on the 
part of the inflamed portion of the fleshy part of the penis, back of 
the head, which prevents it from participating in the enlargement of 
the penis. It sometimes happens that this fleshy part undergoes 
permanent diminution of its size, and after that when the penis is 
erect it is distorted. Sometimes, too, when this diminution extends 
entirely through the fleshy part to a certain point, afterward, erection 
is only practicable from the root of the organ up to the point of en- 
feeblement. 

Treatment. The only reliable preventive measures, which can be 
recommended, is the avoidance of all danger of infection. It is hoped 
that further suggestions for the benefit of dissolute men, who desire to 
continue their irregularities unpunished are not needed here. 

The best results are to be obtained in a perfectly recent gonorrhoea, 
before the symptoms have become severe, as it then generally can be 
cured in a few* days. Patients, usually from shame, often from 
neglect allow the disease to run along, until it continually increases 
in extent and violence, so that each day of delay makes it worse. To 
check and thoroughly cure this loathsome disease, purchase at any 
respectable drug store three powders, each of which is to contain one 
drachm of tanin. Take one of these powders and dissolve it in a 
half pint of red wine and use the folution as an injection. If the 
result is unsatisfactory, take the remaining two. powders and dissolve 
them in another pint of red wine and use as before, this doubly strong 



IMPOTENCY. 219 

solution. In order that these injections may be of service, the patient 
should see that the syringe enters the opening of the penis, if you do 
not use this precaution, the solution may only penetrate between the 
head and foreskin, where, of course, it will do no good at all. It 
should also be observed that the syringe you purchase does not hold 
any more fluid, as can be propelled into the urethra, and that its point 
is smooth, where it enters the penis. We do not believe it to be the 
proper thing to place these remedies into a family medicine chest and 
hence refrain from it. Should any young man, however, be so unfor- 
tunate and void of honor, as to contract this disease, and be ashamed 
to ask his druggist for the articles necessary for a complete cure, he 
can write to us and we will supply him complete treatment at cost 
price to us. Cases of gonorrhoea of long standing, take special 
treatment and should be handled, according to the circumstances by a 
physician. During treatment the patient must live on a very light 
diet, abstaining from all alcoholic and malt beverages, tea, coffee, 
spices and fatty food. 

Nocturnal and diurnal Pollutions, are emissions of semen, either dur- 
ing day or night, otherwise than at sexual intercourse. 

These involuntary emissions are not so weakening as the public 
generally believes, but still, if not looked after, they become excessive 
and then are very debilitating. They happen to men from time of 
puberty till his virile power has been lost, but chiefly among young 
men from seventeen to twenty-five years. In most cases they are the 
result af former errors and of masturbation. People having these 
emissions are usually driven to fear or even hypochondria, by reading 
the numerous books nowadays published by unscrupulous physicians 
in the endeavor to terrify people, who have erred in youth, in order 
to catch their dollars. 

Treatment. Lead a regular life, do hot handle your sexual organs, 
ieep your bowels open, by an occasional Pill Cath. Comp. Vegetable, 
Bottle No. 17, and wash every morning upon arising, your sexual 
organs in very cold water. It is also well to have some one sponge 
you along the spine with cold water. 

Impotence, or weakness of the male sexual organ. During the period of 
manhood, complete and permanent inability of performing sexual 
intercourse is of the rarest occurrence. Even some deformities of 
the penis, loss of one testicle, or disease of both, does not necessarily 
cause absolute impotence. Cases of diminished power and temporary 



220 IMPOTENCY. 

impotence are of frequent occurrence. Unhappy marriages, barreness, 
divorces, or even an occasional suicide can be prevented, if the persons, 
imagining himself impotent, understands that his case is not a grave 
one, and that about all they need is consolation and time, in which to 
exhibit their manhood. The persons, that are chiefly afflicted, are 
young husbands, whe are rilled with despair at the discovery that they 
cannot cohabit with their wives. Not only sensual women, but all, 
without exception, feel deeply hurt, and are repelled by the husband, 
whom they may previously have dearly loved, when, after entering 
the married state, they find that he is impotent. The more inexperi- 
enced and innocent they were at the time of marriage, the longer it 
often is before they find that something is lacking in their husband; 
but, once knowing this, they infallibly have a feeling of contempt and 
aversion for him. It is not the lost pleasure, or the fear of remaining 
childless, that makes the young husband nearly crazy and seeks the 
aid of the physician, but a sense of shame, and the knowledge that he 
is becoming contemptible and disgusting to his wife. 

Under proper treatment the great majority of these cases terminate 
well, so that, when the desperate spouses fall into the right hands, in 
the course of time, they almost always become happy husbands and 
fathers. The most frequent cause of temporary impotence is lack of 
self-confidence and a consequent straining of the mind for the success 
of the sexual intercourse. Erections not only come without the in- 
fluence of the will, but the ardent desire for them interferes with their 
occurrence. The more unconcerned the individual, the less attention 
he pays to the erections, the more certain and permant they will be, 
when there is sexual excitement. Patients of this class often have 
powerful and continued erections at times, when they are of no use to 
them, bat have none, when there is opportunity for coitus, or that, if 
erections occur, they pass of even during the coitus, before the 
ejaculation takes place. Even when such persons have regained their 
self-confidence by a successful sexual intercourse, and have retained 
their power for some time, they often have long relapses of their im- 
potency from a single failure of the act. There are also cases, who 
have coitus with their wives at short intervals, without the least 
trouble, but always fail, if they make an attempt with some other 
woman, with whom they had no previous connection. 

The most frequent cause of this diminished power is onanism; 
sexual excess or repeated pollutions are far more rarely the cause. 
The diminished power of the onanist is first increased to temporary 



INFLAMMATION OF THE OVAKY. 221 

impotence by reading popular and medical treatises on the result of 
masturbation. In those writings the loss of manhood is described as 
the inevitable result of onanism and the despondency from reading 
these papers act on the same person, the first attempt at sexual inter- 
course almost always fails. The effect of this first failure is to induce 
subsequent ones for a time. Intoxicated persons never can have a 
successful coitus. 

In many, many cases the only cause for the failure of the first 
coitus are excessive excitement and a certain embarrassment and 
anxiety. Such persons have often led an unusually chaste life, and, 
with a rare innocence after marriage, they have attempted coitus, 
being perfectly ignorant of the process. In the first weeks of their 
married life they are greatly depressed and troubled by their sad 
experience. If you meet them a few years subsequently, when they 
have healthy blooming children, and you are intimately acquainted 
with them, they laugh freely over the mishaps of their honeymoon. 

Treatment. It must be of a phychical nature and let the patient be 
assured that his case is of very little importance and only temporary. 
As soon as a patient notices that he cannot successfully perform 
sexual intercourse, he should abstain from it entirely, and in this 
endeavor, any sensible young wife will assist her husband. During 
this intermission, the young husband will acquire a nonchalence and 
the erections will become stronger and more lasting. He should not, 
however, try to make use of it, till he is certain of success. After the 
first success, let him not overestimate his abilities, else he fails again 
and the old trouble is only increased. Persons suffering from impo- 
tence are particularly warned against artificial excitement, such as 
fingering or rubbing the gentials and thus attempt to excite erections. 
The effect is most injurious, and the procedure one of indecency. 
"Washing the genitals with cold water, cold hip baths, and cold douches 
are of much benefit. All the medicines advertised to restore "lost 
manhood" and cure "seminal weakness" are useless and injurious and 
should not be resorted to under any circumstances. The habitual 
use of stimulants in the shape of liquor is injurious and often the 
cause of impotence. 

Inflammation of the ovary. Childbirth and its sequels most frequent- 
ly causes this disease, also rush of blood to the ovary, especially 
around the time of mensuration, if complicated with catching cold, 
getting the feet wet and sexual intercourse, through last mentioned 
period. One attack of the disease predisposes to another. 



222 CATAKRH OF THE WOMB. 

Symptoms. Secretion of mucus and bloody discharge from the 
uterus, pain in passing water or at stool, neuralgic pains and numb- 
ness in the vicinity. In favorable cases the symptoms pass off within 
a few days, without leaving any traces. 

Treatment, Take frequent baths and apply frequently warm poulti- 
ces of corn meal to lower abdomen. Cause copious evacuations of the 
bowels by injections of lukew aim water or moderate doses of castor 
oil, but use no violent purgatives. In regulated case instead of bath- 
ing in plain warm water, make a strong hot brine of salt and water in- 
stead. 

Ovarian tumors and cysts are diseases of the ovary and very complica- 
ted. Eemedies are alone in the hands of of a skillful surgeon. Medi- 
cines are of no avail. 

Catarrh of the womb, leucorrhoea or whites is a congestion of blood to 
that organ and the formation of mucus in it, same as in other catarrhs. 

Causes. Congestion of the blood vessels of the uterus during 
menstruation. Heart and lung diseases, direct irritation of the womb, 
which is often caused by too energetic coitus, by masturbation, and by 
wearing, on the part of ladies, of apparatuses having a tendency to 
interfere with the course of nature. 

Symptoms. The disease usually begins with symptoms of severe 
congestion of the pelvic organs, with pain in the lower regions, with a 
feeling of fulness and weigh in the pelvis ; pressure on the lower part 
of the abdomen gives the patient pain. When the disease is mild 
these symptoms usually appear without fever, but when severe, which 
is usually the case in irritable persons, the symptoms are accompa- 
nied by slight fever. After three or four days the patient will notice a 
discharge from the gentials, at first transparent and sticky; it leaves 
grey spots on the underclothes; afterwards it becomes cloudy, more or 
less purulent, and leaves yellow spots on the clothes. In most cases 
the pain and any accompanying fever disappears in from eight to four- 
teen days. The discharge also becomes less about this time, or a little 
later it looses its purulent nature and finally disappears entirely. This 
is the usual termination of the disease if taken care of in time, but if 
allowed to run, the acute stage is followed by chronic catarrh of the 
womb. The latter is a tedious and very painful disease. It may 
drag on for years and often defies all treatment. Women suffering 
with chronic catarrh of the womb can conceive, but the result is usual- 
ly a premature birth, a miscarriage. 



IlwLAMMATION OF THE WOMB. 253 

Treatment, Inject into the sexual organ a solution of one quarter 
teaspoonful of alum, bottle No. 1, dissolved in one-half pint of luke 
warm water, for five days. Purchase of any respectable druggist two 
bottles of Hunjadi Mineral water and take it, on an empty stomach, 
every morning one wineglassful; after the evacuation of the bowels 
which will follow, take one quiniae pill, 2 gr., bottle No. 16. Strong 
nourishing diet, cold compresses to abdomen, regular habit, abstaining 
from sexual intercourse, liquors, wine, and especially tea, are necessa- 
ry for a thorough cure. 

Inflammation of the womb. This disease may occur in any alult 
female and is sometimes a serious complication of pregnancy or of 
childbirth. The disease may be acute and chronic. The neck of the 
womb is generally the part involved, and the ultimate tendency of 
inflammation of the deeper tissues of the womb is towards ulceration. 

The prevailing causes are exposure to cold, sitting or standing on 
damp ground, suppression of the menses, excessive sexual intercourse 
and mechanical irritation. 

Symptoms, The disease usually commences with a chill, followed 
by a slight fever, full, jerking pulse, thirst, nausea and vomiting, and 
sometimes diarrhoea with straining. The bladder is irritable with 
frequent desire to urinate. There is also a feeling of throbbing in 
the womb, which is swollen and painful. The patient usually pre- 
fers a recumbent position, as sitting up aggravates the pain. The 
disease nearly always begins during menstruation, and then the bleed- 
ing ceases suddenly. In favorable cases the malady runs its course in 
from eight to fourteen days ; the symptoms subside gradually and the 
disease ends in perfect recovery. The disease must be treated in the 
beginning, if not it will become chronic and is then very hard to cure. 

Treatment. In inflammation of the womb the bowels are usually 
constipated and this must first be remedied by giving injections of 
lake warm water, to which a little common salt has been added. 
Then apply to bowels (lower part) hot poultices made either of linseed 
or corn meal ; make them about one and one half inches thick, so that 
they keep the heat well, and change as soon as cooled. If the 
inflammation is accompanied by offensive discharges from the vagina, 
cleanse the same by means of injections of warm water. In aggra- 
vated cases it is recommended to use the Hunjadi James Hungarian 
Mineral water for two or three weeks, every morning, a wineglassful 
before breakfast. 



224 FALLING OF THE WOMB. 

Contractions and closures of the womb. In young persons who develop 
late, moderate degrees of contraction of the neck of the womb are 
quite frequent. They hinder conception, without rendering it impos- 
sible. They impede the escape of menstrual blood and cause it to 
collect temporarily in the uterus and are expelled by painful contractions, 
commmonly called colic of the womb. The disease usually disappears 
after marriage and first childbirth. However, should there be much 
trouble, it is recommended to consult a surgeon, with a view to have 
an astringent injected into the womb, which will give relief. 

Curvatures in the womb, flexions, deviations in position, such as 
anteversion, retroversion, falling ox descent and prolapse of the womb. 

This class of diseases are affections of the womb, which are very 
movable and in consequence thereof, have become dislocated, in di- 
rections as the names indicate. 

Auteversion is the displacement of the womb m such manner that its 
whole axis is directed further forward than usual and most frequently 
occurs in women with strongly curved pelvis. 

Retroversion is a state when the womb is displaced towards the back. 

Falling and prolapse of the womb depends chiefly on relaxation of 
the part that maintains the womb in position, particularly its liga- 
ments and the vagina. If during this relaxation of the ligaments a 
strong pressure from above downwards act on the womb, the latter is 
pressed down, inverts the vagina and passes deeper into it, and the 
result is falling of the womb. If part of the womb protrudes the lips 
of the vagina, it is a prolapse. Eelaxation of all the parts that shonld 
maintain the womb in position occurs most frequently during child- 
bed, and it is the abdominal pressure that most frequently presses the 
womb downward. Women who cannot take care of themselves dur- 
ing confinement, but are obliged to do hard work, which causes abdom- 
inal pressure, a few days after delivery, such as washing and sewing 
in a bent posion, are peculiarly liable to these latter troubles. Falling 
of the womb seldom occurs in women who have had children. If it 
takes place suddenly, as occasionally happens from lifting heavy arti- 
cles, or from severe coughing the stretching of the ligaments causes 
severe pain in the abdomen, and great general disturbances, fainting, 
nausea, etc., etc. If the descent develops slowly; there is usually but 
little annoyance at first, consisting chiefly in an undecided feeling of 
pressure downward and in stretching pain in the lower part of the 
abdomen and small of the back. There is also pain and inconvenience 



MENSTEUATION 22£ 

in urinating and in stool. The trouble is also usually accompanied 
by constipation, colic, pressure and tension. 

Treatment. As all dislocations of the womb are somewhat different, 
depending on certain circumstances, no general rule for the ameliora- 
tion and cure can be given here, but we cannot recommend too 
strongly to consult the best surgeon in your neighborhood, who will 
see at a glance what suspensory or supporter is necessary. His direc- 
tions as to care and mode of life should be strictly followed, in order 
to expect a permanent cure. 

Tumors of the womb also belong to the relm of surgery, and for 
their radical cure, a surgical operation is necessary. Of late years 
nearly all these operations are successful and void of danger, if in 
skilled hands. 

Menstruation. Irregularities in the menses or periods, as also the 
functions of menstruations are called, are not independent diseases, 
but are symptoms of affections of the female sexual organs or of other 
diseases impairing the general health. 

In the female the periodical excitement of the generative apparatus 
is known by a group of phenomena, known under the different names 
of menstruation, menses, periods or courses, and is one of the most 
important functions of the female organization and constitutes a real 
monthly crisis. 

During childhood the sexual system of the female is inactive, but at 
the ages of from thirteen to about sixteen years, a change becomes 
visible. The outlines of the body grow more rounded, the breasts in- 
crease in size, and the entire aspect undergoes a peculiar alteration, 
dependent on the approach of maturity. At the same time a discharge 
of blood takes place from the generative parts, accompanied by some 
general disturbancss of the system. When these changes of life have 
taken place, the young girl is known to have arrived at the period of 
puberty. 

Afterwards the discharges recur at intervals of four weeks, and 
from their correspondence in time with successive lunar months, they 
are designated also as her "monthlies." These periods are usually 
regular in recurrence from their first appearance until about the age 
of forty-five to forty-seven years. During this time woman is capable 
of bearing children, and sexual intercourse is liable to be followed by 
pregancy. After the last mentioned ages, these periods first become 



226 MENTRUATION. 

irregular and then cease, their final disappearance being indicative 
that pregnancy cannot again take place. 

Between the ages of sixteen and forty-five or six the regularity of 
the menses indicates to a great extent the aptitude for impregnation. 
All causes of ill health, which derange the mensis are very apt to 
interfer with pregnancy, and women, who are regular in their menses, 
are more likely to become pregnant, after sexual intercourse, that 
those in whom the periods are absent or irregular. 

When pregnancy takes place, however, the menses are suspended 
during its continuance. They also usually remain absent, after de- 
livery until the time the baby is weaned, when they recommence, and 
xecur at regular intervals as before. 

When the menstrual period is about to come on, ladies are usually 
affected with some degree of discomfort and lassitude, a sense of 
weight in the pelvis, and a more or less disinclination to society. Of 
course these symptoms vary, some very pronounced, and others less so. 
It begins with a discharge of vaginal mucus, which soon becomes 
yellow or rusty brown in color, from the admixture of blood, by the 
second or third day it has the appearance of pure blood. The unpleas- 
ant sensations, at first decided, then usually subside and the discharge, 
after continuing for a few days longer, then grows more scanty. Its 
red color diminishes in intensity, becoming brownish or rusty, until it 
finally disappears, and the process comes to an end. 

As puberty advances, no mother should neglect to teach her 
daughter, to expect the change, which is about to take place so that 
first appearance of the menstrual flow, may neither be arrested by the 
alarm naturally felt at something heretofore inexperienced or unknown, 
nor by the dangerous applications, to which, through ignorance, the 
young girl might resort to. Some young girls look at theii develop- 
ment with disgust to such extent, that they are not even careful of the 
great changes taking place within themselves. Contract cold, take 
cold bath with a view to clean themselves, or endeavor to check 
nature in its course. These indiscretions will bring on disordered 
menstruation and, too often permanent ill health. The time of 
puberty is also an opportune one for mother or guardians to inform 
their daughters or wards of the destiny of women, as laid down by the 
creator, that she or they are the medium of reproduction of the species, 
and that in the near future, when properly united in wedlock, they 
are liable to become the sublimest of all creation — a mother. If 



PREMATURE MENSTRUATION. 227 

mothers will lay these cold facts before their daughters at this time, 
they will save themselves as well as their offspring oftentimes dis- 
grace, which can easier happen to the innocent, than the young girl, 
who knows from her own dear mother's mouth that it is immoral and 
wrong within the eyes of God and mankind, to allow herself to be 
used as the medium of reproduction, or for the satisfaction of the 
illicit desire of a conscienceless man, without the bonds of matrimony 
to a man, who equally returns her love, and between whom 
that congeniality exists, which contributes so much to the unbounded 
happiness of a well matched pair. 

As to the irreguliarities of the menses, different symptoms make 
their appearance, but all show disturbances in the organism, which 
must be pacified. Among the earliest of these are : 

Premature menstruation, must not always be credited to an early 
developement and the natural consequences, but occurs quite often 
through a fall, violent jumping or severe mental emotion for the first 
time. In such cases there may be a considerable flow, and lasting for 
several days. Mothers should be aware of these facts, so that in 
extreme cases they may maintain their own composure, and through 
it inspire it in their daughters. 

Treatment. Pacify your child by kind words, and give her 5 to 10 
drops of Hoffman's Anodyne, Bottle No. 25, in a little sweetened 
water. Place your little patient in bed, in a lying position, light 
covering, keep room cool and well ventilated, give when girl is thirsty, 
lemonade as cool as possible, but not iced, and the flow will soon 
become normal. 

Tardiness in first menstruation. When all the external signs of wo- 
manhood have appeared and menstruation does not occur, but there 
are aching, fulness and heaviness of the head, bleeding from the nose, 
palpitation of the heart, shortness of breath, one slight exertion, 
weariness of the limbs, pains in the small of the back, in lower parts 
of the bowels and down the inside of the tighs, it may be regarded as 
indicative that nature is endeavoring to establish the important func- 
tions of menstruation, but is somewhat hindered in its course. It is 
of the utmost importance to establish the cause of these obstructions. 
Delay of the menses, giving rise to the symptoms just noted, very 
rarely occurs in the healthy and vigorous girl, but follows as a conse- 
quence of original delicacy of constitution or of some long standing 
affection. An old saying holds good, and should be remembered : 



228 TREATMENT. 

"A girl is not sick, because she does not menstruate, but she does 
not menstruate because she is sick." Tardy menstruation is especially 
significant in those girls, who are predisposed to any form of consum- 
ption. In these persons it implies a frail body, in which the menses 
may not appear at all, or in which the flow of blood is very liable to 
seek egress through the lungs. Any young girl from 14 to 18 years of 
age, who has not menstruated, and has a cough of difficulty in breath- 
ing, sore throat, hoarseness, or pain in her side, it is symptomatic of 
very bad health and measures for ljer relief should be at once established. 

Treatment. Internal medicines should not be taken and all the 
articles known to force the menses are more harmful than good. 
When tardiness of the menses is established for good cause as above 
described, put your patient on a very nourishing diet, both meat and 
vegetable, avoid all heavily spiced dishes and tea and coffee. Good 
plain nourishing food, and as much milk as is desired by the patient. 
Induce her to take lots of outdoor exercise in the morning, such as 
riding, walking, running and even the skipping of the rope is one of 
the best things. Never allow her to overtire herself. About evenings, 
half an hour before bed time, immerse her hip in a tub of hot water 
so that her feet and trunk are out of it, covering them by means of 
blankets. The bath should be taken for at least ten minutes, then 
she should be thoroughly rubbed dry and put to bed, in a well ventilated 
room. 

Under no circumstances administer any kind of medicine to a 
young girl thus afflicted, except by special directions of your family 
physician. 

Under certain conditions of long delayed menses marriage is an 
admirable remedy and has established these functions with a surpris- 
ing regularity, but mothers or guardians cannot be too careful to 
adopt this course and should never do it, before they have obtained a 
professional opinion from some good physician, who has formed it 
after a careful consideration and diagnosis. The physician alone can 
establish the cause of the tardiness of menstruation, and if this be the 
general health or imperfectly developed sexual organs, your daughter 
will not be alone disappointed in the expected remedy, but her hus- 
band also is made part in it, and the two suffer. 

Sujiptession of the Menses. When menstruation has once been estab- 
lished, it is liable to be suppressed by different causes. 

The most frequent of all the causes, and towhich no danger, what- 
ever is attached is the happy event of pregnancy. In the young wife 



|u(i( 



PAINFUL MENSTRUATION. 229 

it is surely a time for rejoicing, for it is one of the first signs of ap- 
proaching motherhood. 

Occasionally it is the consequence of weakness, from sedentary 
in-door occupations, combined with want of fresh air and sufficient 
rest, chronic and acute diseases; sexual excesses and mechanical 
obstructions, or it may quite suddenly occur during the flow, from 
exposure to cold or dampness, such as getting the feet wet, sitting on 
damp ground, eating or drinking very cold substances, violent emotions, 
such as anger, terror and fight. - 

Too much indulgence in sexual intercourse will often stop the 
menses for two or three periods without pregnancy. 

Women are very liable to contract this very troubleseme 
disease if they persist in making a deformity of themselves by 
tight lacing and wearing apparel. The injury this penicious fashion 
bringg forth, beggars description. It interfers with the circulation to 
such extent, that diseases are formed beyond the healer's art. To say, 
however, too much on this subject would be injudicious, as the women 
who persist in making a deformity of themselves will not acknowledge 
the wrong they do to themselves, to their prospective offspring and 
to their husband's. 

Treatment. In ordinary case, without complication, take a hot foot 
bath, to which a handful or two of common salt has been added and 
make a tea of tansy, drinking of it freely. Plain nourishing diet, 
avoid stimulants including tea or coffee. 

Painful Menstruation is usually caused by a congested condition of 
the secretory vessels of the womb, diseases of the ovaries, constipation 
and a contracted opening of the womb. In obstinate constipation, 
the rectum becomes often packed with excrementory matter and dis- 
tended through it. Though it pressess on the neck of the womb and 
renders the escape of menstrual fluid difficult and extremely painful. 
Ovarian irritation often induced by self-abuse causes pain during 
menstruation. Ladies of neuralgia, hysteric or rheumatic tendency, 
generally suffer likewise. 

Symptoms. Severe bearing down pain in the neighborhood of the 
womb, somewhat similar to the pain of labor in childbirth, 
and occurring in fits; aching in the small of back, loins, pelvis, and 
even extending to the limbs; headache, flushed cheeks, hurried 
breathing, palpitation, and general nervous debility. These symptoms 



230 CHANGE OF LIFE. 

sometimes precede the flow several hours and even days, and keep up 
till the discharge is thoroughly established. 

Treatment. If from constipation, which is usually the cause, take 
one day before the arrival of the period, at bed time, one pill Cathartic 
Comp. Vegetable, and if constipation during the time of the menses, 
still exists, take frequent injections of luke warm water, to which a 
little vinegar has been added. Ladies thus afflicted should take lots 
of outdoor exercise and eat food, which they know is easily digested 
by them. 

During intervals between menstruation, cold or warm baths are of 
much benefit, dry rubbing and the warming of flannel over lower 
abdomen are necessary. Sexual intercourse must cease at least three 
days before the appearance of the menstrual period, and the patient 
must rest in a reclining position. 

In aggravated cases, the wearing of cat's fur hair next to body over 
abdomen and small of back gives permanent relief. 

Profuse Menstruation is produced by too great a determination of 
the blood to the womb, and superinduced by too much exercise, 
strains, injuries, violent passions of the mind, check of perspiration, 
abortion, difficult or tedious, labor and general debility. In rare 
cases it is also caused by too energetic sexual intercourse. 

The symptoms are those of approaching menstruation, with perhaps 
a little stronger headache, giddiness, shortness of breath and severe 
pains in back and loins, thirst, slight fever, and a strong hard-beating 
pulse. 

Treatment. Prevent bodily exertion and mental excitement and 
keep patient in a horizontal position during menstruation. All stimu- 
lating food or drink must be avoided during the period. As a drink 
cold lemonade is to be recommended. In aggravated cases when 
bleeding is profuse, the family physician should be called in and the 
case left to his care. 

Change of life or cessation of the menses is a disagreeable period 
every woman will have to pass and she can expect it whenever she is 
beyond the fortieth year of life; seldom earlier. This period varies 
greatly; some get over it easy, others it takes a longer time; yes, often 
it is lengthened to 4 or 5 years. It is no disease and the course of 
nature should not be interfered with. Very often during this period 



u 



CATARRH OF THE VAGINA. 231 

complications arise, which are symptomatic of disease, but these can- 
not be generalized and must be left to the physician. 

Catarrh of the vagina, gonorrhoea, is the same disease as gonorrhoea 
in the male. This disease is not induced by sexual excess, but only 
through infection of gonorrhoeal matter, or unclean cohabitation with 
the opposite sex when thus afflicted. 

Symptoms. The first symptoms of gonorrhoea in the female, is a 
feeling of itching and warmth in the sexual organs, and a scanty 
mucous discharge, are not very characteristic and often remain un- 
noticed. After a few days from the commencement of the disease, 
there are severe burning pain in the genitals, swelling of the lips of 
the vagina, and a desire to urinate. These troubles rarely become so 
severe as to interfere greatly with walking, sitting and moving the 
body. The secretion which in this stage is yellowish green, thick and 
purulent often oozes up in large quantities between the lips, even to 
the anus. After the disease has lasted a fortnight or three weeks the 
pain abates and ceases, the discharge looses its purulent appearance, 
but continues a long time till the secretion dries up and looses its 
power of inoculation. 

Treatment. The same local treatments is prescribed for gonorrhoea 
in men. In addition scanty diet, free stool, long continued baths, 
where the hip is only immersed tend to lessen the pain. If there are 
no symptoms of inflammation, make injections into the vagina of luke 
warm water in which a half teaspoonful of alum, bottle No. 1, has 
been dissolved. In very obstinate cases introduce into the vagina 
wads of charpie, sprinkled withe alum, bottle No. 1. 



Skin Diseases. 

SKIN. 

INFLAMMATION of the skin is usually caused by heat, the direct 
rays of the sun, mechanical and chemical irritation and is mani- 
fested by a rush of blood to the skin. If this is then allowed to 
act with greater intensity, it gives rise to red patches or inflammation. 

Symptoms. Inflammation, arising from local irritation, is char- 
acterized by red, slightly prominent patches, the color of which 
gradually becomes fainter at the edges. They become pale, when 
pressed upon, and assume a yellowish tinge, and when the pressure is 
removed become red again. The spots are the seat of more or less 
pain. 

If caused through solar rays, blisters are formed upon the burns. 

When it arises from the friction of two opposing surfaces it is called 
intertrigo, or chafing of the skin. This is very common among in- 
fants, especially among feeble ones, appearing in the folds of the skin, 
upon the genitals, behind the ears, and in the neck. It also appears 
underneath of hanging breasts of very corpulent females. "When it 
arises between the nates or buttocks, from the continuous friction 
upon one another during long walks, the seat is usually between the 
crotch and is then called "the wolf." Continuous confinement and 
sameness of position in bed will also cause it. Discharges from nose 
and eyes also causes abraisions of skin. 

Treatment. If resulting from local irritation, it will soon subside 
when the exciting cause is removed. "When the burning pain is severe 
apply cold water. Intertrigo as in babies, dust cornstarch or magnesiaj 
bottle No. 11, on afflicted parts, afterwards wash with castile soap 
and apply Vaseline, bottle No. 14. Chaffed mouth and face. Wash 
thoroughly and apply glycerine, bottle No. 10. "Wolf," wash with 



ERYSIPELAS. 233 

castile soap and apply vaseline, bottle No. 14; next morning wash 
again and apply magnesia, bottle No. 11, or corn starch. 

Erysipelas is distinguished by an intense hyperaemia of the skin and 
by a profuse serous translation, not only into the skin itself but also 
into the underlaying tissue. It is liable to form abscesses and impli- 
cate the glands in the inflammation. It is also liable to result in 
rupture of the small blood vessels and consequent bleeding into the 
skin and upon its free surface. Violent mental emotions seem to have 
an influence in producing the disease, especially in persons who have 
suffered from it before. It occurs generally in middle age and is 
more common in women than in men. It occurs oftener in 
warm than in cold weather. 

Symptoms. They are preceded for some days by a general disturb- 
ance of health, accompanied more or less by fever. The first local 
symptoms of the disease, while developing is a sense of heat, pain in 
skin, which is not yet red or swollen. Soon the skin begins to redden 
and to swell. At first the redness is speckled and clear, but soon 
becomes diffuse and dark. The swelling increases and soon becomes 
extreme, especially where the skin is attached to the parts beneath 
by loose connective tissue (as in the eye lids) where it renders the 
skin smooth and shining from the tension. With the swelling the 
sense of fullness and burning increases. At this period there is al- 
most always a violent fever, which grows worse towards evening. 
The pulse is usually full, beating from one hundred to one hundred 
and twenty times per minute, and the temperature rises to 105 o F. 
The thirst is increased and appetite lost. In erysipelas of the ,face, 
the mucous membranes of the mouth and tongue sympathize with the 
inflammation of the skin. There is usually signs of violent 
catarrh of the ear. The tongue is heavily coated and dry from effects 
of fever; the taste in mouth is slimy and bitter. 

Erysipelas of the face almost always involves the eyes, ears, hairy 
scalp, and a portion of the throat, but scarcely ever attacks the back 
of the neck or trunk. Its whole duration is from a week to ten days, 
seldom longer. The process terminates in the peeling off of the cuti- 
cle in large pieces, even where there were no blisters. If the scalp 
has been inflammed, the hair always falls out soon afterwards. It 
does not cause, however, any permanent injury to the hair follicles > 
hence the baldness which it occasions soon disappears completely. 

Wandering erysipelas generally attacks the extremities and spreads 



234 RINGWORM. 

towards the trunk and head It usually advances steadily, so that the 
disease, while subsiding in one place, is commencing in the immmedi- 
ately adjoining one. This form is not so severe as the stationery 
erysipelas. 

Treatment. This disease, if allowed to have its run, nearly always 
tarminates favorably without much medical treatment. At most, en- 
velop the inflammed parts in cotton and when the skin is very tense 
and painfnl apply cold compresses. The fever must be combatted 
with quinine and give of it at eight, ten and twelve o'clock mornings 
one two grain pill, bottle No 16. A great many people are in favor 
with so-called "sympathetic treatment" and "remedies" and it is a 
known fact that even educated people take stock in conjuration. The 
remedy is quite harmless and if the patient receives comfort from it 
this humbug can be applied without danger. 

Herpes or ringworm is an eruption of the skin and is confined exclu- 
sively to the most superficial layers thereof. Fever sores around mouth ; 
those face eruptions appearing towards the end of febrous disease, be- 
longs to this class. 

Symptoms. According to the location of the body when the disease 
makes appearance it is grouped. Thus lip herpes or sore lips is situ- 
ated there and often extends over the mucous membrane of the mouth. 
Face herpes, when it attacks the outer part of the genitals it is called 
pudendalis. Herpes zoster or shingles extend along the skin nerves in 
a very peculiar manner. All forms of Herpes begin with a sense of 
burning pain, usually not of a very severe character, in the afflicted 
regions. Numerous red points soon become visible, which coalesce, 
forming red specks of irregular shape which on the next day usually 
are covered with a small transparent vesicle* The contents of these 
vesicles, which rarely exceed the size of a split pea, become turbid in 
two or three days or reddened from an admixture of blood. About 
the fourth or fifth day the vesicles commenee to shrivel, and they and 
their contents subsequently dry up into a brownish scab. The scabs 
fall off in 10 or 14 days after first appearance and for some time 
there remains a reddish spot, covered with very thin skin. 

Treatment. Always runs a favorable course. Bathe freely in luke 
warm water and apply vaseline, bottle No. 14, to afflicted spots; in 
severe cases add a little carbolic acid, bottle No. 5, to vaseline. 

Nettle rash is an eruptive disease of the skin and is caused by the 
following : 



SALT-RHEUM. 235 

Local irritation of the skin from contact with stinging nettles. 

In some persons when they eat strawberries, crabs, clams, mush- 
rooms or other unaccustomed food. It also accompanies fever. 

Symptoms, Usually when in bed, and after getting warm, the 
patient feels an intolerable itching on the neck, anus or body, and on 
scratching soon discovers large welts, which burn, tingle or smart and 
are the source of great discomfort. It is sometimes accompanied by 
fever, which, with the itching, torments the patient to such extent as 
to cause delirium. 

Treatment. Sponge the skin where afflicted and surrounding parts 
with ice water in which a small qnantity of cream of tartar, bottle No. 
6, has been dissolved (about half teaspoonful to a glass of water.) 
Apply very cold. 

Eezmea o*- Salt rheum. A troublesome, inveterate eruption, appear- 
ing on different parts of the body. 

Symptoms. Consist of itching, accompanied by irresistible scratching. 
Very small eruptions or vesicles appear which break and discharge a 
thin, corrosive fluid, that causes a great degree of irritation or itching; 
afterwards scabs often form upon the part affected, which after being 
removed will reappear. The skin is always more or less swollen and 
inflammed, and then the degree of itching is so intense that the 
patient is compelled to scratch continually in order to obtain relief. 
The condition of the blood has a great deal to do with the disease. 

Treatment. Take a warm bath every day and soap your whole body 
thoroughly, remain in bath about 15 minutes. Rub dry and apply to 
afflicted parts vaseline, Bottle No. 14, to which a few drops of carbolic 
acid 10% C. P., Bottle No. 5, has been added. The bath and oint- 
ment must be kept up for a considerable length of time. Then take 3 
teaspoonfuls of cream of tartar, Bottle No. 6, and 3 teaspoonfuls of 
sulphur, Bottle No. 15 and add to it one cup full of pure sugar drips, 
of this mixture take one teaspoonful before breakfast. Relief will 
soon come, After cure, the daily habit of bathing, using lots of soap, 
should be kept up. Nourishing diet, no spices, coffee, liquor. Out- 
door exercise is beneficial. 

Psoriasis, abnormal growth of skin. 

Symptoms. This disease always commences with small round spots 
upon the skin. These are reddened, project slightly above the sur- 
rounding level, and immediately after their appearance are smooth } 



236 BAEBEES ITCH. 

looking as if the covering of the skin had been raised by a serious 
effusion, and had sunk back again after the liquid had been reabsorbed. 
This small, round, red, infiltered spot soon becomes covered with dry 
white scales. The favorite seat of this disease is upon the knees and 
elbows, but from there often ranges over half the body. 

Treatment. Bathe for a half hour in very warm water, soap afflicted 
parts well and rub with brush till scales all disappear. Apply thick 
coats of vaseline, Botttle No. 14, adding a few drops carbolic acid 
1(3% C. P., Bottle No 5, and cover the spots with flannel. Put 
patient to bed in a very warm room. Eepeat for about four or five 
days. If constipated, give injections of luke warm water. Meagre 
diet. As a drink, give lemonade. 

Sycosis or Barbers Itch. It is an inflammation of the sebaceous glands 
and of the deeply rooted hair follicles, also take part in this inflam- 
mation, and become the seat of swelling infiltration and suppuration. 
The disease never occurs in women or children, who never shave; but 
only affects adult males, particularly at a time, when the beard has 
acquired a pretty thick growth. Dull razors, awkward shaving, the 
effect of irritating soap, or dirt cause the disease. 

Symjrtoms. The disease commences with a sense of heat and 
tension, accompanied by the development of red infiltrated nodules, of 
of the size of a small pea, between the hairs of the beard upon lips, 
chin, cheeks. After a while little elevations, containing pus, which 
are always perforated by a hair, appear upon the lips of the nodules. 
The little elevations or pustules burst in a day or two and pour out 
their contents, which immediately dry in a brownish crust. The 
nodulents still continue beneath the crusts, and even, after the latter 
have fallen, they diminish very slowly or not at all. The disease 
spreads very rapidly, however, it is sometimes confined to a small 
spot, and at other times, the whole face, where hair grows, is covered 
with dusky red nodules, pustules and scabs. The disease is of in- 
definite duration, and often lasts for years without subsiding, if not 
checked in proper time. In old cases, when it does heal, the hair 
follicles having been destroyed, the hair does not grow upon the 
affected spot, and then presents the appearance of a scar. 

Treatment. All the scabs must be softened and be removed by rub- 
bing them with oil, or by the application of a rag saturated with oil, 
best for this is olive oil. Then shave or get shaved every day, not- 
withstanding your own or your barber's protest, it does not hurt so 



ITCH. f 237 

much as you imagine. The pustules, which afterwards appear, must 
then be pricked open, by means of a thin knife or needle. It does 
not hurt. Then wash your face, where afflicted with very strong 
vinegar, which smarts a little in the beginning. During night cover 
affected part with a rag saturated with an ointment made of equal 
parts of sulphur, Bottle No. 15, glycerine, Bottle No. 10, and alcohol, 
(five cents worth from any drug store will suffice.) This is a radical 
and specific cure and leaves your skin afterwards in a nice healthy 
condition. After complete cure, the wearing of full whiskers is recom- 
mended. 

Itch or scabies. The itch is an inflammation of the skin, character- 
ized by the formation of nodules, vesicles, and pustules and is caused 
by the presence of an annual parasite — the itch mite — , it is recogniz- 
able to the naked eye as a round white body and when viewed under 
the magnifying glass resembles a tortoise in shape. The young 
insect has six, but the adult is supplied with eight feet, the anterior 
pair of which are supplied with suckers. These little mites burrow 
little passages into the skin in which their eggs are deposited. Sleep- 
ing with a person, afflicted with the itch is a very dangerous procedure, 
while a very brief pressure of the hands of a person with itch, will 
already suffice to transplant ODe of these little mites upon new ground. 
Symptoms. Generally speaking, a patient is first made aware of 
his having the itch, by an intense itching, which is worse, when he is 
in a warm bed, than in a cold place. The itching is strongest be- 
tween the fingers, toes, genitals, upon the legs, abdomen and chest. 
Objective symptoms are nodules, pastules and vesicles in variable 
number, which in children and thin skinned persons are liable to 
suppurate. 

Itch never becomes well spontaneously, but is very amenable to treat- 
ment, hence it may be considered an innocent, but very disagreable 
disease. 

Treatment. In as much as the medicine required for the cure of 
this disease is quite bulky, it cannot be well placed into the medicinic 
chest, especially so, as it is an obsolete disease, hence apply to your 
next druggist for the following ointment : 

E. Carbonate of potash 2 drachm 

Sulphur J ounce 

Lard 2 ounces 
M. In aggravated cases get three or four times the above 

dose. 



238 CORNS AND BUNIONS. 

Take one or two strong soap baths in very warm water, after drying, 
rub the ointment all over the body, excepting the face, or, at all 
events, over any spot where any eruptions or traces of itch can be 
found. This rubbing in of the above ointment must be repeated 
two or three times a day. By this means the disease can be cured 
with certainty in from eight to fourteen days. After cure it is well to 
rub all over the body a little petroleum or coal oil, leaving it on for 
half an hour and then take a bath. It has a tendency to kill off the 
last vestige of the mites. 

Corns and bunions sue caused by badly fitting footwear. They cannot 
be removed, if a person with a No. 8 foot, insists to wear a No. 6 shoe. 
Cutting and paring is the best remedy to make them less objectionable. 
In corns of early growth, cotton saturated in a solution of common 
washing soda, tied over the corn, and left there over night, will losen 
them occasionally to such extent, that they can be pulled off without 
pain. 

JVarts. Purchase a small quantity of nitric acid (poison) and touch 
the warts with same, by means of a glass stick or piece of wood. It 
will etch them a, way. 

Sore nipples on breast. Wash carefully three or four times a day 
with luke warm water, into which a few drops of carbolic acid 10% 
C. P., Bottle No. 5, has been put. During this treatment the baby 
must be artifically fed. 

Perspiring hands and feet. Can be ameliorated through frequent 
bathing in cold water. It should not be suppressed under any circum- 
stances. 

Chapped hands and face. Apply vaselins, Bottle No. 14, or glycerine 
Bottle No. 10. If the skin is cracked, before making the application 
take of Borax, Bottle No. 3, one-half teaspoonful in one-half glass of 
luke warm water, dissolve, apply to wounds and cleanse thoroughly 
with the solution before using vaseline or Glycerine. 



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Diseases of the Organs 
of Locomotion. 

EHEUMATISM 

IS a disease characterized by painful, often multiple local inflamma- 
tion, usually affecting the joints and the muscles, and sometimes 
extending to the deeper organs, as the heart. There are 
several kinds of rheumatism. 

Acute articular rheumatism or rheumatism of the joints. In this class 
of rheumatism the synovial capsule of some of the joints, sometimes 
only one is the seat of inflammatory disturbance. 

The predisposition to rheumatism of the joints is very unequal in 
different persons. Some seem to inherit a predisposition. Those 
who have had one or more attacks are very liable to have another. 
The disease is rare in childhood and old age, and occurs most fre- 
quently between the ages of fifteen and forty. The predisposition 
seems to be somewhat stronger in robust and fullblooded persons, 
than in those who are weak. 

Among the inducing causes of rheumatism of the joints, the more 
important are; temporary exposure to cold, by suddenly wetting the 
heated body, or by being subjected to a draught, and continued resi- 
dence in a damp dwelling and working in damp shops. 

Symptoms. In some cases the outbreak of the disease is preceded 
for a few days by general uneasiness and a feeling of weariness of the 
limbs.. In others the attack begins suddenly and unexpectedly. It 
does not always commence with fever as in most inflammatory 
diseases. There is usually a small chill, repeated during the first 
few days followed by a hot feeling. Just as these fever symptoms 
begin, or soon afterwards, the patients complain in one or more joints; 



RHEUMATISM. 239 

moderate at first, but increasing rapidly and soon becomes very 
decided. As long as the patient makes no attempt to move the 
affected joints, and is not touched, the pain is endurable; but every 
attempt to move or the slightest pressure on it, sometimes even the 
weight of the bedclothes, increases the pain so that the patients often 
moan and cry till they have remained quietly in a comfortable position 
protected from any injury. Upon examination, the affected joint will 
be found to be more or less swollen. If the pain and swelling disap- 
pear slowly in the joints first sized, while they develop in others the 
number of joints implicated at one time may be very large, and the 
patient's state be very helpless and pitiable. Occasionally such 
patients cannot make any movement; they are unable to stir from 
any position in which they have been placed ; they fear even the most 
careful passive motion rendered necessary for urination, stool, eating 
or drinking. Even slightly shaking the bed increases the pain and 
induces groans and complains. This extent and severity of the 
symptoms are not frequent. In most cases two or three, or at least a 
moderate number of joints are simultaneously affected with severe 
pain, while the others remain free, or are somewhat stiff and only 
gain when freely moved. 

Fever usually accompanies the commencement of the disease, and 
during it the temperature is somewhat elevated. Pulse is frequent, 

to 100 per minute, full and soft. The respiration is hastened, the 
skin is always covered with profuse perspiration of acid odor. 
Through this perspiration, thirst is hightened and the urine lessened. 

The disease has no regular course, but with varying intensity from 
one to six weeks or even longer. 

The termination of the disease, if it remains uncomplicated with 
heart troubles, is usually a favorable one. 

Treatment. A strong nourishing but easily digestible diet, no hot 
drinks of any kind, coffee and tea are better eliminated, wines and 
liquors, including beer are harmful. The room should* not be kept 
too warm, but its temperatuie should be regular and even as possible. 
Then give of quiniae pills 2 gr. Bottle No. 16, 2 at eight a. m., same at 
10 a. m. and two more at noon. At four o'clock give of Phenacetine 
Bayer, Bottle No. 23, one dose, repeating every two hours till patient 
sleeps. 

The following linament you can prepare and rub it gently, but 
persistently on the afflicted parts. 



240 CHKOXIC RHEUMATISM. 

Take one fresn egg and place it in a water glass, fill the glass with 
pure strong vinegar, this will dissolve the egg, shell and all, it takes 
about twenty-four hours, then add double quantity of turpentine and a 
few teaspoonfulls of sweet oil, shake well and apply as directed. It 
is a paltiative. , 

Chronic articular rheumaism, is the name applied to a chronic, peculiar 
inflammation of the joints, which usually attacks only one or a few 
joints, which usually attacks only one or a few joints, and which, in 
spite of its long duration, induces comparatively little anatomical 
changes. When it leads to suppuration it is a chronic inflammation. 
This form of rheumatism often develops from the acute form, but 
oftener it appears as a chronic form from the start. 

The predisposing causes are the same as in acute rheumatism. 

Symptom*. Are about the same as in the preceeding, occurring at 
short intervals, in which the joints once affected, become again so. 
Persons suffering from this form often become rheumatic at every 
change of weather, everytime they are expose to a draught and often 
without any perceptable cause. The joint affected is slightly swollen, 
very sensitive to pressure, but particularly painful when moved. The 
fever, which is almost always present, is evinced by continued frequent 
pulse, constant perspiration, by thick sedimentary urine, and by 
gradual emaciation of the patient. This form of rheumatism, when 
once taken root is very obstinate and may last for life. 

Treatment. It must be mainly local by using the liniment pre- 
scribed in acute rheumatism ; to which should be added one teaspoon- 
ful of oil of mustard, bottle No. 12. The afflicted joint should be 
rubbed with this preparation at least four times a day and then be 
covered with flannel bandages. In the first stages of chronic rheu- 
matism of the joint, cold water douches, applied to the afflicted part, 
often cures the disease, when in the insipient state by lessening the 
flow of blood to the inflamed parts. The friction caused by a stiff 
brush or an electric brush is very beneficial. Patients should wear 
habitually flannel next to the skin. If pain is very strong the intern- 
al medicines prescribed in acute rheumatism should be used in the 
same manner. Cases of long standing receive much benefit from 
electricity, if applied in a thorough manner and by a physician who 
understands his business. 

Deforming articular inflammation are those swollen misshapen joints, 
and is usually the consequence of rheumatism not properly cared for. 



GOUT. 241 

It will mostly be noticed in persons not having the means to treat 
rheumatism when afflicted with it. 

Treatment. Little hope for cure can be extended to the sufferers 
with this disease unless they can go to the famous haths at Topliz, 
Bohemia. Cures have been effected there. 

Muscular rheumatism is applied to all rheumatic diseases which 
affect the muscles, fascia, the periosteum and other fibrous tissues, 
except the joints. 

Symptoms. The most important and usually the only symptom of 
muscular rheumatism, is the stretching and tearing pain. Moving or 
rubbing the affected tissues increases the pain, while pressure will 
generally diminished it. The skin covering the part does not appear 
red or swollen, or warmer than the surrounding parts. The pain is 
usually more violent towards evening and lets up towards morning. 
It is generally made worse by cold and dampness, and improved by 
dry warmth. But sometimes the warmth of the bed increases the 
pain. Muscular rheumatism is sometimes wandering, that is, the 
pain leaves one place and appears in another. Then, again, in others 
it remains fixed to a certain muscle or groupe of muscles. It can 
occur in almost any part of the body, sometimes gradual, then again 
with a surprising rapid occurrence. The latter is specially the case 
when rheumatism attacks the loins, when it is usually called "lumba- 
go." 

Treatment. The best constitutional remedy for muscular rheuma- 
tism is a good sweat. Therefore make for your patient a very hot 
lemonade, using the juice of two lemons, which must have been peeled 
before the juice is squeezed out. Put him to bed and cover him with 
blankets and keep him in perspiration as long as possible. Liniments, 
plasters, ointments do not do much good. Of local treatment,, 
"Massage" "stroking" and "kneading" the painful muscles is of 
much benefit and should be resorted to after the sweat. In very pain- 
ful cases give one or two doses of phenatecine bayer, bottle No. 23. 
Patients afflicted with this class of rheumatism should habitually wear 
flannels, both winter and summer and avoid cold damp places. 

Gout or Podagra is the result of overindulgence in the pleasures of 
the banquet table, or who drink champaign, wines or beer regularly 
and take little or no exercise. The disease is also heriditary. 

Symptoms. An attack of gout almost always comes unexpectedly, 
in spite of the previous warning, and surprises the patient like a thief 



212 TREATMENT. 

in the night. After he has gone to bed, without dreaming of the com- 
ing evil and has gone quietly to sleep he is awakened, generally soon 
after midnight by a severe, burning, piercing pain in the joints of the 
great toe. The pain rapidly becomes unbearable. The patient feels 
as if the afflicted joint was in a vice. He sighs, moans, throws him- 
self around in bed, the leg or even the entire body trembles with pain. 
Soon after the attack the skin covering of the affected joint becomes 
swollen and reddened, and there is fever, with a full bounding pulse, 
dry skin, intense thirst and great mental excitement. Towards morn- 
ing there is usually a remission and during following day the suffer- 
ing becomes endurable. The next night the scene of the past one is 
repeated, but with less severity and so on, until the attack abates, and 
the patient is temporarly free from his trouble. The first attack of 
gout hardly ever leaves any deformity, nor does it affect often any 
other joint than that of the great toe. 

After the patient has recovered from his pain and sleepless nights, 
he usually feels better than before the attack. 

Treatment. Gout can only be treated by regulating the habits of 
the patient. Gouty patients should not go to big dinners, 
even if they promise to be very moderate. It is best for them to eat 
only vegetables, soups, etc., etc., and to have meat only once a day, 
which must be entirely without fat. The use of alcoholic liquor, 
wine or beer retards the transformation of the tissue and hence is in- 
jurious to gouty patients. Persons but little inclined to the produc- 
tion of fat under the regular and free use of wine, liquor and beer, 
become very obese, and from this mode of life most persons have a 
red face and distended veins until their digestion is impaired or there 
is some other injurious consequence. This consideration, as well as in 
the fact that in persons who drink neither wine nor beer the occur- 
rence of gout is very exceptional, should induce any one afflicted with 
gout to abstain therefrom entirely, or at least to stop their use gradu- 
ally. The same is true of the use of tea and coffee. Although there 
is but little nutrative material in these drinks, still there is no doubt 
that tea and coffee have the same influence on the transformation of 
tissue that wine and beer have. Tea and coffee preserve the strength, 
diminish the need of nutriment, limit the consumption, and hence, 
are injuriuos to gouty persons. 

Drinking large quantities of water has just the opposite effect on the 
transformation of the tissues, from what is induced by the use of tea, 



RICKETS RACHITIS. 243 

coffee, beer and wine. After drinking freely of water no one feels less 
need of food, fatigue is not better borne, it does not induce corpulence 
and a red face, on the other hand it has been shown that, when plenty 
of water is taken, the amount of water passed is greater, than it 
would be under like circumstances, without this increased supply, and 
as the amount of urea excreted after drinking plenty of water is in- 
creased permanently, it is of the utmost benefit to gouty persons. 
Since muscular action also hastens the transformation of tissue and 
the consumption of the constituents of the body, it may be readily 
seen that a lazy, easy life is bad for gouty patients and that very 
active exercise is of the utmost importance in its treatment. 

In gouty attacks no internal medicines should be given, but the 
pain will be lessened by the free use of ice cold lemonade. 

Do not use on the aching joints any cold compresses or hot poultices, 
it will only increase the pain. In very acute pains dining the attack 
give patient every fifteen miuutes about a half glassful of water as hot 
as he can drink it. 

During the attack the afflicted limb should be elevated and covered 
with cotton or wool and the patient placed on a very low diet. 

There is no disease which shows the imperfection of medicine or 
sets the advantage of temperance in eating and drinking, as well as 
healthy exercise, in a stronger light than this. 

Rickets Rachitis, a disease which effects children, and which is 
characterized by bulk heads, crooked spine and limbs, depressed ribs, 
enlarged and spongy enlargements at joints, swollen abdomen and 
short stature, together with clear and often premature mental faculties. 
The essential cause of this disease seems to be nondeposition of earthy 
salts in the bones. Children afflicted with this malady walk and 
stand unsteadily. 

It occurs mostly in children from six months to the sixth year. In 
some families the tendency of it seems to be heriditary. Improper 
nutriment of children is undoubtedly the most frequent cause of the 
disease. Especially the feeding to children of articles of food that 
grown persons can hardly digest, has a tendency to cause in the little 
one's intestinal and gastric catarrh. It is a well known fact that 
rachitis is of very rare ocjurrance in well nourished children who have 
an unimpaired digestion. This is best preserved in the little ones by 
giving them their natural food, the mother's milk, provided the mother 



241 SYMPTOMS. 

is a healty woman, and is enabled to provide in that way sufficient 
nutriment. 

Symirtoms. Impaired digestion and improper food usually causes in 
the babies chronic intestinal catarrh, with diarrhoea at first green and 
mucus subsequently copious and watery. If this system is allowed to 
run on and the child shows strange formation in its bones, rachitis 
may be considered as a natural consequence. 

The first symptom that rickets succeeded the diarrhoea is the pain 
that the children unmistakably suffer when they attempt to move 
their limbs, or when they are moved by any one. Children whose 
greatest pleasure has been to kick out their legs and put their toes 
into their mouth, then lie quiet, with their thin legs held straight out 
as if afraid to move; how they cry at every motion and even begin to 
whimper for fear of being taken out of bed when persons that they 
had formerly loved approach them. These symptoms are succeeded 
by enlargement of the ends at joints, and especially noticeable at 
knee and elbow and also at the ankles. 

If rachitis begins in the manner above described, from diarrhoea, 
that is, if it begins when the child has not attempted to walk, it often 
escapes any distortion of the extremities even if the disease lasts for 
years. This shows that the curvatures, such as bow-legs and partial 
fractures of rachitic bones, are chiefly due to the weight of the body 
resting on them. We must also mention that chronic bronchial 
catarrh is the most frequent complication of rickets early in life; 
its absence is exceptional. In this case teeth are generally cut very 
late, and often irregularly, it frequently happens that a child is a year 
old before it has a tooth in the mouth. If the disease ends in recovery 
the first signs of improvement is generally a decrease of emaciation. 
The loose skin is again filled by the limbs, the wrinkled and old faces 
grow smooth, while the protuberant belly becomes smaller. After a 
while the children begin to sit up in bed and play. At this time there 
is great danger of curvature of the spine, and permanent distortions 
of the w T hole spinal column. At the beginning of convalescence, cur- 
vatures and partial fractures of the extremities also are most likely to 
occur when the children attempt to get out of bed and walk around 
holding on to the chairs. When the children attacked by rachitis are 
two or three years old, the ribs and back bones escape at the com- 
mencement and the extremities become first deformed. They are 
affected with curvatures, and partial fractures, whose directions are 



U'd -si 



TREATMENT. 245 

not always the same. The thighs are usually bent outward, the legs 
inward; the children acquire a clumsy waddling gait. It is often a 
longtime, often many years, before the disease extends to the whole 
skeleton. Even if successful in arresting the disease in the first 
stage, the small size, the misshapen limbs, bow-legs, remind one 
through life of the rickets that occurred during childhood. In severe 
cases very unsightly curvatures and shortenings of the bones remain, 
which not infrequently impair the functions of the body. 

Treatment. In cases where the chronic intestinal catarrh is the 
cause, this disease should be first battled with, as laid down under 
that head. If you succeed in curing the intestinal catarrh speedily 
and completely, and improve the nutrition, the rachitic symptoms, 
induced by these disturbances, also generally disappear in a short 
time, and if the disease be recognized early, the children escape any 
permanent results of the rickets. 

Where the cause is not from diarrhoea, the bones must be 
strengthened by the administration of cod liver oil, of the purest 
quality, commenciug with ten to twenty and gradually increasing the 
dose to a teaspoon ul. Cod Liver Oil is a specific in rickets. Brine 
baths are also of unmistakable benefit and should be used, particularly 
if the children are not too much emaciated. The children must not 
be given any vegetables, at least very little, and should be exclusively 
fed on an animal food. The administration of a small amount of 
finely scraped beef from which every vestige of stringy matter is re- 
moved, twice a day given raw, will soon show its beneficent work on 
the little patient. Commence with about a quarter teaspoonful, and 
ing this stage are very much excited or delirious ; others lie benumbed 
increase gradually, but do not overdo the same. 

Rickets can never be cured, if the youngsters are kept in a damp 
dark room, where no fresh air is admitted. In good weather they 
should be sent out of doors as much as possible. 

To guard that rachitic children do not become bow-legged, be care- 
ful not to put them on their feet, and to avoid curvature of the spine 
you must not let them sit up in bed any length of time. They should 
lie as much as possible till their little bones lose the softness. Chil- 
dren afflicted with this disease should lie on hard mattresses and 
never on feather beds or very soft quilts. High quilts must also be 
avoided. Rachitic children should never be carried around much, 
but be places in a baby carriage, in which they can assume a lying 



246 SOFTENING OF THE BONES. 

posture. Until the bones are consolidated, sitting up in bed for any 
length of time must be prohibited, and still more should the parents 
forbid the children running about on their flexible, fragile legs. If the 
curvature has already occurred, you should send your child to some 
reliable institute, where such diseases are specially looked after, or at 
least consult a surgeon with a view of having some apparatus made, 
which wil] straighten out the curved limbs or spine. 

Osteomalacia or softening of the bones, is a rare but frightful disease, 
and no case is known, which has ended in recovery, it defying all 
medicines. 



Constitutional Diseases. 

MEASLES 

IS a purely contagious disease. It is certain that the blood, tears 
and secretions of the air passages are vehicles for the contagion, 
for inoculations made with these fluids have induced measles in 
previously healthy persons. But, as the disease most frequently oc- 
curs in persons, who have not come in direct contact with either the 
blood or secretions of measles patients, but have been near those 
affected with the disease, no doubt can be entertained, that contagion 
is also contained in the emanations from the skin and lungs. It has 
been proven that this contagion in the atmosphere can, without losing 
its activity, be carried for miles by the body and clothes of healthy 
persons, who have been near a patient, and who are not themselves 
attacked by the disease. The period of incubation lasts from ten to 
fourteen days. Measles are most infectious while the eruption is out, and 
not so much when the scales fall off. The popular opinion, that 
measles are most catching in the scaling off stage, arises from inatten- 
tion to the period of incubation. A child infected by its brother or 
sister breaks out with the disease while the latter is changing its skin, 
it is true, but was infected while the eruption was at its height, or 
perhaps even before the eruption. The probability of the infection 
during the periods mentioned, is supported by the wonderful spread 
of measles through schools. Great care is usually taken to keep out 
of the school any children, who have gotten through the scaling period 
as well as those having any suspicious eruptions, but children with 
catarrh and cough are allowed to sit on seats in the neighborhood of 
well children. 

The predisposition to measles is very extended. Almost every one 
has the disease once during life, but one attack almost invariably ex- 
hausts the susceptibility to new attacks. Most persons are attacked 



248 MEASLES. 

during childhood and have lost the predisposition when they are 
grown up. Children under six months of age often escape during an 
epidemic of the disease. 

Symptoms. During the period of incubation there is no sign of the 
disease. This is followed by the first stage, or forerunner, imitiated 
with repeated weak chills, and accompanied by all the symptoms of a 
severe catarrh. Unless it is known, that there is measles in the 
neighborhood, the most experienced physician can hardly recognize in 
the existing catarrh the forrunner of measles. Increased frequency of 
pulse, hightened temperature, constitutional disturbances, pain in the 
head and limbs, dyspepsia, nausea, vomiting, disturbed sleep, etc., 
also occur during simple catarrh, from catching cold. The local 
symptoms are generally very decided, the burning, reddened 
eyes are filled with tears, there is pain in the forehead, 
the nose is stopped, and discharges a copious, limpid, salty secretion; 
attacks of sneezing occur at short intervals and often continue for 
hours, the voice is husky, the painful cough is hoarse and barking; 
and at night the mother or nurse are afraid that croup has set in. 

The second or eruptive stage commences with an increased violence 
of the fever, the pulse becomes more frequent, the bodily temperature 
rises to the highest point and in isolated, very violent cases, it comes 
even to convulsions. The eruption of pale red, rather undefined spots 
upon the mucous membrane of the cheeks, gums, lips, and back of 
mouth, spreads then to the face, especially about the mouth and eyes, 
and soon to the neck and breast; in about twenty-four hours it reaches 
the feet, so that the whole body is covered. At this time the perspir- 
ation of the little patient has a peculiar odor, which strongly reminds 
of a freshly picked duck or goose. During the eruptive stage, the 
constitutional disturbances and catarrhal symptoms usually increase 
and attain their height. The blooming stage cannot be distinctly dis- 
tinguished from the eruptive stage for in most cases it is at its hight, 
as the eruption is completed. The fever also, which attains its hight 
at the completion of the eruption, rapidly moderates, and sometimes 
disappears in the blooming stage. It is at this time that the parents 
have great difficulty to keep in bed the little patients, who are often 
still covered with red spots, but are already full of spirits. The 
catarrh continues but is of a much milder form, the secretion from the 
nose is more scanty and thick, sneezing is rarer, the voice less rough, 
the cough looser. On the third or fourth day after their occurrence, 



TREATMENT. 249 

they are much paler or have entirely disappeared, commonly leaving a 
bright, yellow discoloration on the skin for a time. 

The fourth stage, or scaling period, sets in on the eighth or ninth 
day of the disease. At this time the spots have entirely disappeared, 
and their former seat is covered by a bran-like scurf. If the detached 
scales be softened and mancerated by constant perspiration, the scal- 
ing is not so evident, as if the skin be dry, hence it is less perceptible 
on the parts covered by bed clothes, than on the face, neck and hands. 
In this latter stage the fever has generally disappearedi Catarrh also 
passes off gradually, and about the fourteenth day or sometimes a 
little later, as the scaling off ends, the measles terminate. Measles, 
if they run in above described course, always terminate favorably, but 
sometimes they are complicated with other diseases and become 
dangerous. 

Treatment. The only effective prevention is a strict isolation of 
healthy persons, w 7 ho have not had the measles from those in whom 
the disease has broken out, as well as from those who are suspected 
of being in the commencing stages. To protect children from the 
affection it is necessary to keep them out of school, and it is still 
better, if possible to send them away from the place where an epidemic 
is raging. Of course, in mild epidemics, this latter precaution will 
not be often resorted to, because we know that sooner or later, almost 
every person has the measles, but in those epidemics characterized 
by their malignancy and fatality, it cannot be too high recommended. 

If measles have once broken out in a person, we must remember that 
there is no remedy for cutting short the attack, and that the majority 
of medicines usually given, do more injury than good. The great 
majority of cases end in recovery without any medical treatment. All 
patients who have the measles should be kept in an even moderate tem- 
perature of 60 ° to 65 ° , which must be regulated by the thermometer, 
and not by guesswork. The chamber must be aired every day , while a thin 
cloth is thrown over the face of the patient and his bed is protected 
from draught by means of a screen. The little patient should be 
washed once a day and the linen changed, whenever necessary. But 
both these operations must be done quickly and without unnecessary 
exposure. The water used in washing should be luke warm. The 
body and bed linen should not be taken from the clothes-press and 
placed directly on the patient, but should be first warmed and aired, 
or, still better, worn for a night by some well person. The chamoer 



250 SCARLET FEVER. 

should be darkened in proportion to the eye troubles of the patient. 
If you make the room too dark, you render the eye trouble worse, for 
the patient is dazzled every time the door is opened, and light enters 
the room. In the beginning and up to the v close of the eruption stage, 
the patient should have nothing but water soups and toasted bread, 
and if constipated, stewed fruit. During the rest of the disease, the 
patient may return to his customary diet. Simple cold water, that 
has stood in the room for a while, should be freely given, as it is 
never injurious, and does not even render any of the symptoms worse 
temporarily. On the other hand, it is cruel and injurious to withhold 
from the patient the only thing that will quench his thirst, as long as 
he is feverish and thirsty, and in place of it make him drink warm tea 
or water. The time that the patients are to pass in bed, and in their 
chamber, should not be measured in the customary way by days and 
weeks, but they should remain in bed as long as there is the slightest 
indication of fever, while the peeling off is going on and the cough is 
severe and should even keep his chamber as long as there is any trace 
of measles, catarrh, whether the customary fourteen days or fourteen 
weeks have elapsed. If in the beginning of the disease, the patient is 
attacked by very severe hoarseness and shortness of breath, which 
sometimes occur, especially during sleep, awake the little sufferer 
and apply hot applications to throat and give plenty of hot drink, or 
try by the spoon method, to have tha patient vomit. If diarrhoea sets 
in give the child a parched flour soup, it will stop it. If during the 
stages of eruption and blooming, the fever is very high, give once a 
day, in the morning of quiniae, Bottle No 16, one pill, one grain 
(small size.) 

Scarlet fever is also an infectious disease. Little is known about 
scarlet fever poison, but it seems to be evident that the poison is 
contained in the exhalations of the patient and is mingled with the 
atmosphere about them. Well proved facts, also render it probable 
that the contagion may be carried by persons who are not afflicted 
with the disease. The period of incubation lasts about eight or ten 
days. It is, however, hard to say when the infection terminates, and 
it is also doubtful in what stage scarlet fever is infectious. 

The predisposition to scarlet fever is far less common than that 
of measles; there are a great many persons who never have had it. 
One attack almost unexceptionally removes the liability to another. 
Nursing children often escape during an epidemic, while those over 
two years old are most susceptible to the disease, but even adults who 



SYMPTOMS. 251 

have not had scarlet fever during childhood are often attacked by it, 
and cases even occur in old age. 

Symptoms. Scarlet fever is quite a serious disease, as many will 
testify, and has perhaps put many a parent's heart into deep mourning 
for the loss they sustained. During the stages of incubation some 
patients complain of weariness and depression and an undefined feel- 
ing of sickness, but most of them feel quite well. 

The prodromal stage or precursor begins with repeated chills. This 
is followed by a feeling of burning heat, nausea or actual vomiting, 
severe headache, feeling of great relaxation, pain in the limbs and the 
series of symptoms that accompanies almost any severe fever. Even 
at this time the pulse is often 120 or 130 beats a minute, and the 
bodily temperature occasionally arises to 104 ° or 105 ° . Such an 
increase of temperature is not often observed at the commencement of 
other diseases, even in inflammation of important organs, hence 
these symptoms alone excite the suspicion that your patient is in the 
first stages of scarlet fever. The patient complains of a feeling of 
dryness and heat in the throat, and of pain which is increased by 
swallowing. On examining the throat, you will find the mucous 
membrane of the tonsils and soft palate dark red* and swollen. In 
some cases the tongue is already very red at the edges. Occasionally 
the prodromal stage only lasts a few hours, or the eruption may occur 
almost at the same time with the fever, so that there is no real pro- 
dromal stage, but in most cases this stage lasts one or two days. The 
intensity, as well as the duration of the prodromal stage varies very 
much in different cases, due to unknown causes. Some patients dur- 
ing this stage are very much excited or delirious; others lie benumbed 
and apathetic ; chtldren not unfrequently have convulsions the same 
as in other febrile diseases. The eruptive stage almost always begins 
with an increase of fever. The symptoms accompanying the fever, 
also the headache, weakness, excitement, and apathy increase, and it 
is at this time that convulsions most frequently occur in children. 
The eruption does not first appear on the face, as does that of measles, 
but begins on the neck and thence extends over the body. Even in 
twenty-four or thirty-six hours, the whole surface is usually covered 
with a scarlet color. In the face the cheeks are generally red, hence 
the discoloration is less readily recognized here than elsewhere. The 
deepest redness is usually on the neck, outside of the limbs, joints, 
hands and feet. The exhalations ef the patient smell like mouldy 



252 TREATMENT. 

cheese. When the eruption appears the throat trouble increases, the 
back part of the mouth becomes intensely red, the tongue is of a dark 
raspberry redness, not only at the edges, but at its back, from which 
the previous coating is thrown off. During the stage of eruption there 
is variations from the above symptoms which have no material effect 
upon the course of the disease. For instance, the discoloration 
spreads over the surface with uncommon rapidity; sometimes the red- 
ness is brighter, at others much darker. In the same way the throat 
troubles are very severe, again very light. They are seldom accom- 
panied by catarrh. 

In the bloomng stage, which usually lasts four or five days, the 
fever at first increases, reaching its height about the second day. At 
the same time the eruption is at its bloom and the throat trouble has 
reached its height. The general health of the patient is also most 
effectual at this time. After this all the symptoms usually begin to 
decrease, the frequency of the pulse and temperature go down, the 
discoloration fades, the difficulty in swallowing grows less and the 
general health improves. 

The peeling off usually begins on the fifth day after the disappear- 
ance of the eruption. While the eruption continues to some extent in 
the extremities, especially about the joints, it disappears about the 
neck, and here you will first notice that the skin is rough and dry, 
the epidermis is raised and falls off in small shreds. A few days later 
the redness usually disappears from the extremities also, and peeling 
off begins. During this, which lasts from eight to fourteen days, the 
last traces of fever and inflammation about the neck disappear, and, 
when the disease runs a favorable course, it ends in perfect recovery 
during the third or fourth week. 

If the course of scarlet fever was always as in the foregoing descrip- 
tion and run in this benign form, not many victims would pay the 
tribute of death to it. But it is not to be so, and how often does this 
virulent disease become complicated with others, and the patients, 
mostly young in years, must give up their lives to the great sorrow of 
father, mother, brothers and sisters. 

Treatment. As the disease favors complications, it is always best to 
call in the family physician in the earlier stages and follow his direc- 
tions as to medicines. Scarlet fever when once set in must run its 
course, just as measles, and if not complicated needs no medicines at 
all, and the complications only must be fought against with drugs. 



SMALL POX. 253 

Prevention is always better ana cheaper than cure, and what was 
said in this regard in the case of measles holds good here. 

The sick chamber should be kept at an even temperature, not ex- 
ceeding 60 ° or 65 ° , and do not weight the patient down with cover- 
ing. Freshen the air in she room occasionally by opening the window 
and have the little patient carefully washed daily. The best drink is 
pure cold water or lemonade; as nourishment, give water soups, toast, 
stewed fruit; later, in the convalescent stage, meat broth, milk, etc. 
In case of constipation give injections of lukewarm water. It is an 
old custom to keep patients in bed until the cutcle has peeled off complete 
ly, and it is well to keep up this practice. Even after the peeling off 
is entirely completed, the patient should be protected from cold and 
in winter should be kept in his room for at least a fortnight. During 
this time he should take several baths in lukewarm water. 

We cannot urge too strongly to call in an experienced physician, 
to combat with the numerous complications which are liable to arise 
which cannot be generalized in this work. 

Smallpox. It spreads solely by contagion. Smallpox poison, which 
is only known from its effects, is contained in the pustules, and in the 
perspiration of the patient having the disease. The poison is most 
active at the period when the clear contents of the pocks begin to turn 
slowly. Smallpox poison is very tenacious of vitality; it is not des- 
troyed by drying. It clings for a long time to objects that have been 
near a patient with the disease, and where protected from the air, 
remains active for years. The liability to smallpox is common to all 
mankind, but expires almost entirely for the rest of life after one 
attack. 

The disease artificially induced by vaccination with the cow-pock, 
has a similar effect on the predisposition. In some persons it seems 
to remove the tendency to the disease for life, while in others only for 
a number of years. 

Symptoms. During the period of incubation there are usually no 
signs of the disease, either in mild or severe cases and this stage usu- 
aUy lasts for 12 or 14 days. 

The first stage of smallpox commences with one or more chills, this 
soon give place to a feeling of permanent heat. Pulse is full temper- 
ature up to 104 ° and 106 ° , face reddened the arteries of neck pul- 
sate strongly, patient has great thirst, loss of appetite, a bruised feel- 
ing of the limbs, coated tongue, slimy taste, nausea and vomiting. 



254 SYMPTOMS. 

Sleep is restless and broken by dreams. Some patients become 
delirious. After imperfect remissions during the second and third day 
the fever and accompanying disturbances usually increase and attain 
their height on the coming of the third day. 

The second or eruptive stage almost always begins with the appear- 
ance of the first pimple on the third day of the fever. It begins at 
the face, and on the next day the eruption usually spreads from there 
to the neck, breast and back, and on the third day to the extremities. 
The number of pimples on the body and extremities is usually far 
less than on the face. The pocks appear late on the extremities, they 
also develop late. The eruption on the mucous membrane begins at 
the same time it does on the skin, but is not generally noticed, as it 
does not cause much trouble at first. The pox in the mouth increases 
the flow of saliva; in the back of mouth, difficulty in swallowing, in the 
air passages, hoarseness and cough; those on the eye, the flow of 
tears. The fever, the severe pains in the loins, and the constitutional 
disturbances, which attain their hight towards the end of the first 
stage, always reunit when the eruptions come out, decrease still more 
as it exten Is to the body and towards the end of the eruptive stage 
the patient usually feels quite well. The third or suppurating stage 
begins about the sixth day after the first appearance of the eruption, 
and about the ninth day after the first symptoms of the fever. The 
pocks become larger ; the bluntness of their summit give place to a 
half round shape. If they be punctured, their thick purulent contents 
escape all at once. The skin around the pocks swell decidedly, and 
become dark red. The redness and swelling becomes diffuse. The 
patients are greatly disfigured, and complain of severe, tense, pulsating 
pain in the reddened skin, which is covered with large pustules. 
More or less of these pustules rupture and their contents flow over the 
surface, where they dry into crust, which at first are yellow, subse- 
quently brown. The suffering at this stage is intense. The fever 
which had moderated or even disappeared during the eruptive stage, 
returns with all vehemence during this suppurative stage, and begins 
anew with repeated chills. 

The fourth or drying stage usually begins on the eleventh or twelfth 
day. During this stage the fever gradually subsides and the dried up 
scabs begin to fall off. It is at this period where the smallpox pits 
become apparent, and not unfrequently, a previously beautiful coun- 
tenance is rendered disgustingly ugly by smallpox. 



TREATMENT. 255 

The foregoing is a description of the more violent forms of small- 
pocks, some pass off a great deal easier and then are called "varioloid" 
and usually persons, who have been vaccinated are afflicted with this 
form when they have come in contact with the virulent form of small 
pox and their system was not thoroughly cleared through the vacci- 
nation process. The death rate in the latter is scarcely four per cent. 

Treatment. The only one is the preventive treatment, which con- 
sists in vaccination and revaccination. All objections to vaccination, 
even if well founded, would have to give way to the facts proved by 
statistics, that in the last century one-tenth of the population died of 
smallpocks, another tenth were disfigured by the disease, and, that 
since Dr. Jenner's great invention and the introduction of vaccination > 
the general mortality is less, and that of smallpox is reduced to a 
minimum. During an epidemic persons, who have been vaccinated, 
but in whom the vaccination has not yet taken, are attacked by small- 
pox and the two diseases run their course at the same time without 
modifying each other. This shows that vaccination cannot cut short 
the disease, during incubation, also that the susceptibility to vaccin- 
ation is not lost during this stage. Besides vaccination and revac- 
cination no one should be deterred by any sentiment or personal con- 
sideration from exercising the most stringent rules + 'or the isolation of 
smallpox patients, even if they should be very annoying for the 
patient and his friends. 

There are no medicines known to science, which can cut short the 
disease and averting dangerous accidents. In the first stage the 
patient should be kept moderately cool, the temperature at about 
60 ° F., bedcovers should not be too heavy, the patient should not be 
dosed with warm tea, but let him have all the cold water and lemon- 
ade he wants, light diet, and if the patient is constipated administer 
an injection of luke warm water, one-fourth of which is pure cider 
vinegar. During the eruptive stage the most attention should be 
paid to the fever and if it becomes alarming, administer large dose of 
quiniae, Bottle No. 16, 3 to 4 of the large pills. In the drying stage 
the patient should have an early digestible but nourishing diet. The 
patient should be warned against scratching off the crust and mea- 
sures should be taken to prevent his doing so during sleep. If the 
crusts be firmly adherent, and specially if suppuration under them 
continue, apply corn or linseed meal poultices, medium hot. It is 
hoped to be needless, to advise, to call in a physioian several times 
during the course of the disease, for the purpose of prescribing such 



256 CHICKEN POX. 

paliatives as circumstances may call for, and which can not be 
generalized and also to counteract the numerous complications this 
disease so often brings forth. All clothes of a smallpox patient, in- 
cluding the bedding he has used, should be burned after cure or 
demise. 

Chicken Pox, also called wind, water or sheep-pox is an infectious 
disease and usually appears in more or less extensive epidemics. 

Symptoms. In some cases the appearance of the eruption is the first- 
symptom of the disease, in rare cases, however, the discoloration is 
preceded for a day or two by slight fever and general discomfort, 
derangement, loss of appetite, headache, etc. The eruption spreads 
spreads over the body without any regularity, but is usually thickest 
on the back and breast. The face often remains entirely free. 
Individual pimples develop in from six to twelve hours, their con- 
tents become cloudy the second day and dry up on the fourth. It is 
rare to have only a single crop of pimples; new crops usually appear 
for several days, so that the disease is often protracted for a fortnight, 
or even longer. The disease is not accompanied by constitutional 
dissurbances. 

Treatment. Is scarcely necessary, as the disease is not in the least 
dangerous, or very inconvenient, and always terminates in recovery, 
after lasting a week or two. Notwithstanding this, it is advisable to 
protect the patients from all injurious influences, cold, draught, etc., 
while the disease lasts, and keep them in their room. The diet must 
also be regulated and is to consist mainly of milk, eggs, toast and 
nourishing soups. As a drink give cool water. Prevent the scratching 
off of the scabs. 

Typhus Fever, also called spotted fever is very closely related to the 
previously described infectious diseases, measles, scarlet fever and 
smallpox, by its contagiousness, and by the local affection of the skin 
in the shape of extensive discoloration, but its symptoms on the 
other hand, also, resemble very much the typhoid fever, to such extent, 
that many authorities consider it a variety of the latter. The disease 
is very contagious and the contagion is contained in the air about the 
patient, in his clothes, bed, linen and other property. Hence the 
treatment and nursery of patients with scarlet fever is much more 
dangerous than is the case with patients having cholera or typhoid 
fever. Like measles, the disease may be carried by persons who do 
not themselves become affected. The susceptibility miasm or con- 
tagion of typhus is very general. Males and females, strong and 



TYPHUS FEVEE. 257 

healthy persons, weak and sickly ones are about equally liable to the 
disease. Only early childhood and extreme old age usually except. 

Excess in exertion and other debilitating influences appear to in- 
crease the predisposition. One attack seems to destroy the suscepti- 
bility to the affection. 

Symptoms. There are few diseases, whose symptoms correspond so 
exactly in different cases, and which run sach similar course in differ- 
ent persons as typhus fever. 

The period of incubation lasts about eight or nine days, during 
which slight chills, headache, disturbed sleep, loss of appetite, a feel- 
ing of dullness, depression and discomfort, in fact a series of sym- 
ptoms, which also appear at the beginning of other diseases, and 
giving no special clue to the disease which is about commencing. It 
only during a prevalence of typhus, that these symptoms arouse 
suspicion, which increases almost to a ceriainty, then, if the symptoms 
are accompanied by catarrhal troubles, cough, burning sensation in 
the eyes. The invading stage begins with a single protracted chill of 
great violence, or with repeated slight ones, followed by a continued 
feeling of great heat. After the first chill, the patient is not able«to 
leave his bed; they feel excessively fatigued and weak, complain of 
heaviness and numbness in head, and headache. These symptoms 
are followed by dizziness, flashes of light, deafness, pain in muscles, 
trembling of the limbs. The patients lie usually in a state of apathy, 
talk in their sleep, and even while awake, emittering delirium. Some 
are very excited and restless, have anxious, wild fantasies and can 
scarcely be kept in bed. Besides these symptoms of disturbed inerva- 
tion, there are almost always signs of intense catarrh during the 
invading stage, the eyes shun the light and are red, there is an in- 
creased flow of tears, the nose is dry and stopped up, the act of 
swallowing also is often difficult and painful, tongue has a white 
coating, the taste is slimy, temperature 104 ° to 106 ° , pulse large 
and about 100 to the minute, thirst is very great. 

With the first appearance of the rose rash, which occurs in the 
second half of the first week, the eruptive and blooming stage begins. 
At first the spots are few in number and only appear on the trunk, 
theme on the neck and extremities, till finally the entire body except 
the face, is covered with them. The discoloration lasts usually till 
the end of the second week. The general symptoms do not improve 
with the outbreak of the eruption. The patient complains, however, 



258 SYMPTOMS. 

less, from pain in the head and limbs, this is only because their mind 
is more affected, they cannot think clearly, give slow and complete 
answers to questions and after their recovery scarcely remember this 
period, during, which they are in a quite or noisy, violent delirium, 
and often make constant attempt to jump out of be 1 and run away. 
Towards the beginning of the second weeek, while the discoloration 
becomes more livid, all the symptoms increase and attain their 
hight about the middle of the week. The patients lie almost constantly 
on their back, eyes half closed, knees rolling outward, the hands be- 
tween the tighs, and are in a deep stupor, from which it is with 
defficulty to arouse them. From time to time they mumble unintel- 
ligently, make grimaces, gesticulate, pick the bedclothes, attempt to 
rise and to thrust the feet out of bed, and it is evident, while all 
shame and propriety is gone and the real world is lost to them, they 
still live in an imaginary world, and their minds are more or less 
active. They do not appear thirsty, but show great avidity for drink 
when you offer them a glass of waier, but they often fail to quench 
their thirst, because the tongue trembles or is stiff, and the act of 
swallowing has become difficult. In many patients while undergoing 
this period, numerous other diseases make their appearance, helping 
of course, to complicate the already serious disease. Pneumonia, 
parotitis, kidney diseases, and collapse of the lungs are of frequent 
occurrence. 

The third or critical period usually begins in the latter part 
of the second week. Before actually seeing such cases, it is almost 
impossible to imagine the wonderful change in the symptoms during 
a single night, in the critical period. In no other disease is there so 
rapid a change, from an apparently hopeless to a very comfortable 
state. After a peculiar marked increase of all the symptoms the 
patients fall into a quiet sleep for several hours, from which they 
awake with unclouded minds, but usually without any recollection of 
what they have passed through for the previous days or weeks. Dur- 
ing this critical sleep, the temperature often falls four degrees, the 
pulse twenty or thirty beats ; the dry heat disappears from the skin, 
and gentle perspiration ensues. The rose rash also becomes pale. 
In favorable cases the cooling off is immediately followed by conval- 
escence, which, however, is always slow. The patients sleep a great 
deal, upon awakening their intellect becomes clearer, although they 
retain an idiotic, stupid expression for weeks. The dirty coating is 
thrown off from the tongue and teeth, the tongue becomes moist and 



TYPHOID FEVEE. 259 

appetite returns. Skin begins to peel off. Temperature and pulse 
become once more normal. But even in best cases weeks pass, before 
patient can leave his bed and move about his room. In many cases 
the mental vigor returns slower than the bodily strength. During 
this last stage the wasted and emaciated condition of the patient is 
very liable to contract new disease, and his impoverished body, not 
being able to withstand this new strain, succumbs. 

Recovery is by far the most frequent termination, if complicating 
diseases do not make their appearance. 

Treatment. No remedies are known to combat or arrest typhus 
fever, and the physician, who naturally will be called in, will have to 
be entirely guided by the symptoms, which manifest themselves, and 
which threaten the life of the patient, particularly the high fever will 
have to be looked after. If you are aware, that the physician you 
call in, knows what he is about, follow his instructions implicitly and 
your patient will be very soon on the road to recovery. 

Typhoid Fever, or abdominal typhus, is a disease, which was formerly 
confounded with Typhus, described in preceding chapter, but differs 
very essentially. It is characterized by fever, lasting usually three or 
more weeks, diarrhoea with stool resembling pea soup in appearance^ 
and prostration and muscular debility, gradually increasing and 
often becoming profound at the acme of the disease. Its local 
lesions are a scanty eruption of spots, resembling flea bites, on the 
belly, enlargement of the spleen, and ulcerations of the intestines 
over the area occupied by Peyer's glands. The vims or contagion of 
this disease is a microscopic vegetable organism and is not so intense 
as that of the spotted fever. This virus clings particularly to the de- 
jections of the patient, and persons who are exposed to the stools of 
them are most apt to be infected. It is very doubtful if the contagion 
be transferred by the exhalations from the skin and lungs, as in 
spotted fever. Infection of the nurses and physicians is rarely seen 
in typhoid fever, and, when it occurs, it is always questionable, 
whether it be due to the emanations from the patient or from his de- 
jections. At all events, using the bed pans, night stools, and privies, 
where the dejections of the patients have been emptied, appears more 
dangerous, than being brought in contact with the patient. 

The miasmatic origin of typhoid fever is a well known fact, and the 
contagious matter is often transferred to the body by drinking water, 
which comes from surface wells, which are supplied with water 



260 TYPHOID FEVER. 

filtered through cesspools, or adjacent cemeteries. In fact any drink- 
ing water, which has been in contact, more or less direct with de- 
composed animal or vegetable matter. It can also be caused through 
inhalation of air, emanating from places, containing decomposed 
matter and in process of decay, sewer gas, or noxious gases arising 
from privies in close proximity to living or sleeping rooms. 

The susceptibility to typhoid poison varies greatly with the 
individual. Persons of old age and infants are seldom attacked, but 
those of middle age are most liable to it; males are more often attacked 
than females ; strong and vigorous persons oftener than weak ones. 
Pregnancy gives almost absolute immunity to the disease. Except in 
very rare cases, one attack removes the susceptibility. 

Symptoms. In many cases, the evident commencement of the 
disease is preceded for days or even weeks by indefinite premonitory 
symptoms. These forerunners are feelings of general illness, mental 
disquiet, great dullness, and relaxation, loss of appetite, indigestion, 
restless sleep disturbed by dreams, headache, dizziness, wandering 
pains in limbs, which are usually considered rheumatic, and nose 
bleeding. 

The disease proper begins, however, when the first chill occurs 
during the above mentioned symptoms, or if there have been no fore- 
runners, when the chill notifies the patient of his illness. The chill 
is rarely so severe and continued as in intermittent fever or pneumonia; 
there is usually no shivering and chattering of the teeth. 

Even during the first week the patient becomes very weak and 
much prostrated, but few can leave their beds during the first days; 
at the same time they complain of headache, which is chiefly in the 
forehead; of buzzing in the ears; flashes before the eyes, dizziness, 
which is particularly severe, when they rise in bed, or attempt to 
walk. The sleep is restless and broken by dreams, in which the 
patient often speaks single words, or whole sentences, in a loud voice. 
During the first week, the patient, while awake, is usually perfectly 
conscious, but shows little interest in things around, and answers 
slowly and unwillingly to questions. There is great thirst, no appetite ; 
there is a slimy or bitter taste in the mouth. Occasionally there is 
diarrhoea, but the bowels are usually constipated, and it is not till the 
end of the week that the patient has several pulpy or even fluid stools 
daily. Under no circumstances should an emetic, or injection be 
given, as it will invariably produce severe diarrhoea, which it is 



TYPHOID FEVER. 261 

nearly impossible to stop. During first week of typhoid, there is 
often repeated nose bleeding, which is not apt to be abundant, and 
which relieves the headache. There is also usually bronchial catarrh. 

Even during the first days the abdomen is generally painful, and is 
very sensitive to pressure in the soft parts above the hips, the naod 
and stomach. The belly is very tense and somewhat pulled up. 
Towards the end of the first week, the spleen becomes enlarged, and 
when patient lies on right side, with left arm. over head it can be 
plainly felt back of the stomach. Toward the end of the first week, 
on careful examination, you often find a few pale red rose rash spots, 
about the size of a lentel, on the abdomen and breast. The most 
important objective symptom is the fever. The temperature rising 
gradually, higher in the evening than the preceding morning. Pulse 
90 to 100 beats per minute and often higher. 

In the second week of the disease the complaints of pain in the 
head and limbs cease, but the dizziness becomes worse and the noises 
in the ears are accompanied by deafness. The expression becomes 
more stupid, the inattention greater; the intellect, which was usually 
clear during the first week, becomes cloudy, and the patient gradually 
falls into a somnolent, stupid state, from which he can only be aroused 
with difficulty, and for a short time. In spite of the dry mouth he 
manifests no desire for water, but drinks with avidity, when a glass 
of water is placed to his lips. Towards the end of the second week, 
the stools and urine are often passed in bed, because the patient does 
not perceive the necessity of evacuating the distended rectum or 
bladder. Many patients lie unconsciously on their backs; if placed 
on the side, the body and limbs follow their own weight, without the 
patient making any attempt to change his position, even if it be un- 
comfortable. The occasional trembling of the lips, or a few incom- 
prehensible words that the poor sufferers mumble, alone show that 
the mental activity is not all lost. Other patients who are just as 
insensitive to the external world, who denude themselves without any 
modesty, do not answer questions, show by their whole manner that 
they are living in an excited dream; they are constantly agitated, 
throw off the bed clothes as fast as they are replaced, attempt to 
stand up or run away, talk loud or disjointed words, gesticulate, speak 
unknown tongues and become morose and angry when they are held 
or in any way restrained. It is astonishing what energy and per- 
sistency such patients often show in attempting to carry out their 
morbid impulses. The objective symptoms also have changed to 



262 SYMPTOMS. 

some^extent in the second week. The cheeks are now more brownish 
red or blue, the eyelids are half closed, there is dried mucus at the 
corners, and the nostrils are smoky looking. A brown, tough coat- 
ing clings to the teeth and gums, and the tongue is covered with a 
brown crust, which gradually becomes blackish. Decomposition of 
the coating of tongue and teeth causes a very disagreeable penetrating 
odor, movement of the tongue is much impaired, so that speech be- 
comes indistinct, chewing of hard substances often impossible and 
even drinking difficult. 

In the third week of typhoid fever the patient becomes excessively 
weak ; he cannot sit up, and if the bed be inclined he slides down 
towards the foot as often as he is lifted up. The somnolence and 
stupor reach the highest point, the noisy delirium ceases, and the 
restlesness gives place to increasing stupor; some patients make 
automatic motions with the hands, pull at the bed clothes and almost 
always pass the faeces and urine in bed. 

Fatal termination is most common in the third week, if not induced 
by some peculiar accident, death results from the water swelling of 
the lungs, after the prostration, weakness, temperature and pulse have 
reached the highest grade. In favorable cases there is a subsidence of 
the symptoms about the middle of the third week. The state of deep 
sleep, from which the patient could only be aroused with difficulty, 
and during which he lived a dream life, gives place to natural sleep, 
While awake the expression of the patient shows that he pays some 
attention to the things about him, which at the height of the dis- 
ease had no charm or existence for him. The first glance in which 
affection and gratitude again appear may be regarded as an advance, 
although the danger is not yet over, and the hopes awakened by this 
and other hopes are often blasted. The more quiet and continued the 
sleep, the clearer the intellect usually is during the waking state. 
They no longer pass the urine and faeces in bed, but call for the bed 
pan when they wish to have a stool or empty their bladder. The looks 
of the patient improve from now on and the tongue looses some of 
its coating. Towards the end of the third or commencement of the 
fourth week convalescence commences, but recovery is very slow, 
owing to the existence of ulcers in the intestines. The appetite, which 
often becomes wolfish during convalescence, may prove fatal, if the 
nurse is careless or the patient intractable. 

Recovery is the most frequent termination of typhoid fever. It 
takes place in about three-fourths of all cases. 



'TREATMENT. 263 

Treatment, It is believed to be needless to say that a physician 
should be called to take the patient in hand and direct what medicines 
are needed. The learned practitioner, from the indications in most 
cases of typhoid fever, will find means to protect the patient from all 
injurious influences combat dangerous symptoms, counteract compli- 
cations and will give directions to maintain the strength of the patient 
by means of a specially prescribed diet. 

The work of the physician can be made much more easy if the 
following rules are strictly observed, and his success depends greatly 
on the co-labor of the nurse and the place where the sufferer passes 
his ordeal. 

If circumstances permit you should see that the sick room is not 
too small and to have it well ventilated. Fresh, pure air is very 
necessary to all typhoid patients, and they do not catch cold so 
readily as one imagines. The temperature of the room should be 
regulated by the thermometer and should be kept as nearly as possible 
between 60 ° and 65 ° . Place a pan of water under the bed. It is 
useful in maintaining a uniform degree of moisture in the room and 
prevents bed sores. The bed of the patient should be carefully attended 
to. The coverings should not be too heavy, and the sheet should 
have no creases in it. The bed and body linen should be changed as 
often as soiled. You must also see to it that the body of the patient 
is kept scrupulously clean, not only face, neck and hands, but also 
all other parts. Even the neatest persons sometimes are neglectful in 
this matter, either from prejudice or fear of injury from exposure and 
fail carefully to inspect the parts about the anus and genitals. These 
parts should be carefully cleansed from any adherent excretions. 
Neglect of this precaution frequently cannot be subsequently made 
good. If the patient is too weak to clean his own mouth, it 
should be done for him, using a linen rag and pure cold water. Par- 
ticular attention should be paid to washing off the sticky mucus 
clinging to the teeth and gums before it dries and decomposes. Even 
when the patient is in a state of stupor, he usually shows some signs 
of pleasure and gratitude after this proceeding. The best drink is 
pure cold water. All additions of fruit juices, vegetable acids, sugar, 
toasted bread, etc., etc., soon become objectionable to the patient. 
The patient must drink freely in order to replace the loss of water 
induced by the copious perspiration. If, during the advanced stage of 
typhoid they do not ask for drink because they do not perceive the 
want of it, it should be offered to them quite often. The diet should 



°64 TREATMENT. 

be one of milk, raw beaten eggs, (about one a day) beef tea, and thin 
oat. meal or barley gruel, properly strained. The longer the disease 
continues, and the greater the exhaustion of the patient the more 
untiringly must the attempt be made to supply nourishing food, but 
always iu very small quantities and in liquid form. In addition to 
these rules of diet, you should wash your patient all over the body 
with pure cold water or with a mixture of three parts of water and one 
of vinegar. This should be repeated several times daily, and should 
be done very carefully with the softest kind of a sponge, so that the 
beneficial and soothing effect may not be annulled by the fatigue 
induced by the act itself. In a mild, regular course of typhoid fever 
no medicine need be given, but should any complicative symptoms 
arise, which cannot be forestalled, the physician in charge will supply 
the necessary remedies. If the fever rises and assumes dangerous 
symptoms, and the physician is not around at the time, do not wait 
for his arrival but administer at once of quiniae 2 gr., bottle No. 16, 
one pill every hour. 

During convalescence the diet of the patient should be most care- 
fully watched. The number who die during convalescence from fault 
of the physician because he has neglected to say exactly what, and 
how much, the patient must eat, or from their own neglect because 
they have not followed the rules laid down for them, is proportionate- 
ly large. It is best to let the patient eat frequently, but only a little 
food at a time, so that the slight amount of gastric juice secreted by 
the convalescent may suffice for its complete digestion. All indigesti- 
ble food, which forms a large amount of faeces should not be used. 
An apparent insignificant digestion, a moderate diarrhoea or slight 
vomiting, should be regarded as a dangerous occurrence, because it 
may induce perforation of an ulcer that has not yet healed. 

Until the time when the patient is completely well, liquid food 
should be the rule ; nothing is gained by haste or by cramming the 
patient with all sorts of things. It is only too often the cause of 
death. Milk, raw beaten eggs, raw oysters, beef tea, strained gruel of 
oatmeal, barley and wheat, tapioca boiled to a jelly, small pieces of 
dry toast. Tender pieces of steaks and chops can be chewed and 
the fibres spit out. Rice well boiled in water and seasoned with sugar 
and fresh milk, and articles of this class are proper food if taken in 
very small quantities at short intervals of say one to two hours. 

The sick chamber should be thoroughly disinfected by taking a 



DIPTHERIA. 265 

piece of wet cloth and droppiug a small quantity of carbolic acid, 
bottle No. 5, on same and then hang it in the room free on all sides. 

The patient should be isolated and not be bothered by any one save 
his nurse. 

During convalescence he must not suffer any mental or bodily ex- 
citement of whatever nature. His mind must be free and have a 
chance to rest from the terrible strain it has undergone. 

Typhoid fever patients take usually a very long time until they are 
completely recovered, and no man can be considered fit for work for 
three or four months after a severe attack of typhoid fever. It is the 
case only too often that patients consider themselves completely restor- 
ed, then over tax the : r strength and succumb after all. 

Diphtheria or Diptheritis is a very dangerous, contagious disease, in 
which the air passages and especially the throat, becomes coated with 
a false membrane, produced by the solidification of an inflammatory 
exudation. The contagion is contained in the false membrane and 
shreds of tissue detached from the diseased parts and also in the air 
breathed out by the patient. Physicians and nurses are in great dan- 
ger of being infected by the morbid product coughed out by the patient 
when they are painting and cauterizing his throat, or opening the 
w T indpipe in very severe cases. 

Science and humanity have to mourn the loss of a number of excel- 
lent physicians and brave nurses who fell victims to diphtheria while 
in the line of duty. The numerous cases of infection of persons who 
have been in the same room with diphtheriatic patients without the 
disease coming in their immediate vicinity, proves that the air exhaled 
be the patient, which does not contain shreds of tissue, is a vehicle for 
the contagion. Children are more subjected to it than adults, how- 
ever, the latter are by no means free from contracting the disease. 

Symptom*. The disease almost always begins with apparently in- 
significant and harmless symptoms. In most cases the general health 
is disturbed a few days before the disease breaks out; the appetite is 
less; the patient complains of dullness, depression and chiliness. At 
the same time the patient complains of difficulty in swallowing, but in 
most cases this is no greater than it usually is in simple catarrh of the 
throat. If the fauces (in vicinity of the root of the tongue) are not yet 
covered with false membrane, but only somewhat reddened and swol- 
len at this stage, diphtheria can only be suspected or recognized when 
it is known to be epidemic or that persons about the patient have, or 



266 DIPTHERIA. 

have had, the disease. Not unfrequently the persons about the pa- 
tient have their attention first called to the disease by swelling of the 
tonsils, the complaint of slight difficulty in swallowing having passed 
unnoticed. It is usually not recognized as diptheria by other people 
than physicians, until the whitish gray spots or patches in the fauces 
are noticed. When this sure sign is visible you need have no doubt 
whatever that you have to deal with a very dangerous and malicious 
foe. Even if the disease begins mild with hardly any symptoms and 
the grey patches are only small and far between, it is no guarantee 
that the disease will terminate favorably. 

If the disease has begun violently ; if a chill and repeated vomiting 
have been the first symptoms, the subsequent course of the disease is 
also usually more severe. The difficulty of swallowing generally re- 
mains moderate and the fever does not become very high, but the 
patient grows pale, the eyes become dull, the pulse small and usually 
frequent, rarely retarded ; the patients are very sluggish and apathetic. 
In many cases the putrefaetion of the false membrane causes a pene- 
trating foul breath. The swelling of the glands of the neck becomes 
more marked; the enlarged glands are very hard and resistant, but 
have no tendency to suppurate. Even after a few days death may 
occur from general paralysis, while the intellect remains clear. Some 
patients whose state had not excited any anxiety and whose general 
condition was previously satisfactory, die unexpectedly with the symp- 
toms of general collapse without our being able to find any explana- 
tion for the occurrence. 

However the most malignant forms of diphtheria do not always 
prove fatal and many pull through and as soon as the ulcers in the 
back part of the mouth heal up, the glandular enlargements subside, 
the depression of the patient disappears and perfect convalescence fol- 
lows in two or three weeks, but is usually a long time, before the 
patient recovers entirely. 

The disease as above described is greatly modified when the dipth- 
thtriatic inflammation extends to the larynx and windpipe. Then 
the symptoms are complicated with hoarseness, loss of voice, excessive 
swelling and symptoms similai to croup. This complication occurs in 
the mild as well as in the severe cases. Even such cases may end in 
ultimate recovery, but most of the patients die, some with the symp- 
toms of collapse; some with those of insufficient respiration (suffoca- 
tion) and poisoning of the blood. 



MALARIAL FEVER. 267 

Even when the disease ends in recovery it is often followed by 
paralysis. Some become speechless, others have great trouble in 
swallowing, while in some cases the extremities have become entirely 
paralyzed. If any of the poison gets into the eyes it may cause blind- 
ness. 

Treatment. All persons coming in contact with diphtheriatic patients 
should wear a guard over their mouth and nostrils and thus protect 
themselves from contact with the false membrane and shreds of tissue 
coughed up by the patient. One of these guards is best made of cot- 
ton flannel in the shape of an apron about 6 inches wide and 3J inches 
long, tied behind the head by means of strings. This cloth should be 
moistened with water and sprinkled with carbolic acid, c. p., bottle 
No. 5. When circumstances permit those who have nothing to do 
with the care of the patient should keep out of the sick room. 

As soon as the false membrane has formed, it should be removed 
by a physician or surgeon, who will also apply such pelliatives as 
may be necessary. The majority of physicians will agree, that in very 
severe attacks, the most prized remedies are useless. After the sur- 
geon has lemoved the false membrane, the patient may slowly swal- 
low small pieces of ice and gargle with a solution of chlorate of 
potash, Bottle No. 7, one teaspoonful to a glass of cold water. If a 
cure can be effected, your family physician will provide the necessary 
remedies, but be prepared, whatever hope the good man may hold out 
to you, the poor little sufferer may be called to his creator, before 
you imagine or can comprehend that you are at once childless. The 
disease is one of the most treacherous in existence and calls for many 
victims. 

It would be impossible to generalize the numerous complications 
and phases arising in diphtheria, and only a trained professional man, 
a physician, can battle with them, and to whom you should leave the 
management of the patient, following his directions at all events. Do 
not wait too long before you call him, you would grieve and be 
troubled with everlasting sorrow, to be informed by him, when he 
does arise, that it is too late and that your child is beyond the stage, 
where human skill cannot interf er with the course of this malignant 
disease. 

Malarial Fever — Intermittent Fever — Chills Fever. This fever results 
from infection of the body with a poisonous substance, called malaria 
or mash miasm. Malarial fevers are endemic chiefly in marshy or 



268 INTERMITTENT FEVER. 

swampy regions, and in such places the number of persons affected 
increases or decreases according as circumstances favor or do not favor 
the decomposition of dead vegetable matter in the marshes. If it 
grows very cold so that the swamps freeze up, the intermittent fever 
ceases. The same thing occurs when in dry seasons, the marshes 
entirely dry up, or if, in very wet seasons, a thick layer of water 
protects the mouldering bottom of the marsh from the action of the 
sun and air. On the other hand, in swampy regions, hot seasons, is 
not too dry, so that the sun's rays can act freely on the exposed but 
still moist bottom of the swamp, are characterized by the great preval- 
ence of intermittent fever. 

There are extensive sections of country, where the circumstances 
for the formation of malaria exist everywhere, in all parts of which 
intermittent fever accurs; but there are also small circumscribed 
malarial areas, where numerous cases of intermittent fever are seen 
every spring and summer, while the whole surrounding country re- 
mains free. Every age, both sexes, and all constitutions, have a pre- 
disposition to intermittent fever and it occurs in all climes, that are 
not very dry, except in the frigid zones. 

Symptoms. It usually takes ten to fourteen days after exposure to 
miasm, that the real malarial symptoms make their appearance. An 
attack of intermittent fever consists of three stages; Chill, Fever 
and Sweating. The chill begins with a fit of weakness and great 
faintness, the patients gape and stretch their limbs. These symptoms 
are soon accompanied by a subjective sensation of cold, at first con- 
sisting of cold shivering over the skin ; afterwards of continued chilli- 
ness so that the patient wants to wrap up as warmly as possible. 
"When the chill increases, the limbs tremble involuntarily, the lips 
quiver, the teeth chatter, and the whole body is often shaken around 
in bed. When the chill beginsl there is also more or less headache, 
oppression of the chest, and hurried respiration; the latter and the 
quivering of the lips, render speech indistinct and interrupted; there 
is also often vomiting if the chill comes on after eating. The patient 
during the chill has the appearance as if he had been exposed to 
severe cold. The size of the body appears diminished, the face 
sunken, the nose pointed, the rings are too large for the fingers. The 
cold stage lasts from half an hour to three hours. In the first attack 
it is usually shorter and less severe than in subsequent ones and its 
intensity and duration generally decrease again if the disease lasts for 
a long time. 



SYMPTOMS. 269 

The hot stage does not begin suddenly but gradually; at first the 
chill is only interrupted by temporary flashes of heat and a permanent 
feeling of warmth comes on by degrees. The headache becomes more 
severe, the patient grows restless, and not unfrequently delirious and 
somewhat stupid. The feeling of oppression on the chest increases, 
while the breathing almost always becomes deeper, fewer and slower. 
Thirst is greatly increased, the appearance of the patient increases, the 
color returns to the skin, the pail, livid look, the loose flesh, the blue- 
ish hue of the lips and finger ends disappear, the face becomes flushed, 
the previously small pulse grows strong and the enlargement of the 
spleen increases. In the hot stage the bodily temperature is increased 
and at the actual commencement of this stage the tempeaature of the 
blood reaches the heighest point and remains there till towards its ter- 
mination, when it gradually begins to fall. All these symptoms show 
that the spasms of the muscles have disappeared. The duration of 
the hot stage varies; sometimes it is only a few hours. In severe cases 
the dry heat continues six, eight and even twelve hours before a 
pleasant perspiration breaks out on the skin. 

The surating stage begins with moisture in the arm pits and on the 
forehead; but soon the perspiration, at first moderate, but later very 
copious extends all over the body. The patient feels greatly relieved, 
the headache remits and gradually disappears, the mind becomes clear, 
the oppression passes off, respiration becomes normal, the thirst is 
less annoying, the palse is soft, full and less frequent. Daring the 
sweating stage the bodily temperature pradually falls and towards its 
end becomes nearly normal. When the attack is over and the inter- 
mission most patients fall into a deep sleep, from which they awake 
much fatigued and dull, but feeling otherwise pretty well. 

According to the rythm in which the attacks follow each other, the 
malarial or intermittent fever is distinguished as re-occurring daily or 
nearly every twenty-four hours. Every other day, where the inter- 
mission is forty-eight hours, and in some cases the intermission is 
three days. The most frequent are the daily and every other day 
occurrences. 

Treatment. In order to prevent this extremely disagreeable disease, 
that the injurious influences which notoriously favor the development 
of the disease, should be as much as possible avoided. Moreover, per- 
sons obliged to reside temporarily or permanently in malarial regions, 
should observe certain rules, which afford more protection than pre- 
ventative medicines. They are as follows: 



270 TREATMENT. 

Eat much pepper, drink plenty of lemonade and strong black coffee, 
avoid eating at night, drink only water which has previously been 
boiled, wear clothing suitable for the time and temperature, protect 
your body by warm under clothing against the morning dew and 
cool evening air, and keep the windows closed at night, live in a 
dwelling, situated high and dry, above the marshes, avoid getting wet, 
errors in diet and other excesses favor the bringing on of the disease, 
avoid as much as possible green vegetables, milk, and bathing in rivers, 
especially after sundown. Sleeping in the open air seems to be most 
dangerous. 

As soon as the first symptons of the chill is observed, the patient 
should go to bed, but do not allow the piling on, of too many bed 
clothes, as they do not warm the skin and only interfere with the cir- 
culation in the skin and impede respiration. If the chill be very 
severe, the skin may be rubbed with a warm woolen cloth, and warm 
woolen cloths, and warm bottles placed in bed. Hot drinks neither 
relieve the chilliness nor increase the temperature. If the patient 
however insists on drink during chill a very moderate quantity of hot 
er, without milk or sugar is not harmful. If the patient becomes 
collapsed during chill, give strong black coffee and rub patient with 
hot woolen cloth. In the hot stage, relieve him of some of the cover- 
ing and give plenty of cold drink in small quantities. If there is 
much rush of blood to the brain, use cold compresses on forehead. 
The sweating period must be awaited in bed. On day after the chill, 
the patient should take one or two Pills Cathartic Comp. Vegetable, 
bottle No. 17, and after he has had a good evacuations of the bowels, 
should be very careful as to his diet, avoiding all fats, milk and butter, 
and only partake of the lightest of food in very small quantities. One 
large dose of Quiniae, bottle No. 16, should then be administered, 
giving an adult five two-grain pills, a person in his teens, two pills 
and a child under ten, one pill. Children should not be given any 
Comp. Cathartic pills in this disease, but a simple injection of luke- 
warm water to which a dash of vinegar has been added. 

If the chill recurs mark the time and in future omit the cathartic, 
but give two hours before chill comes on, the same dose of quiniae. 
This will usually break the chill and the patieut will not be bothered 
again, provided he lives up to the rules laid down in this chapter. 

Should, however, the malarial fever become chronic in a patient, 
write to the publishers of this work and proper remedies to effectually 
cure the chronic form will be provided at cost price. 



ASIATIC CHOLERA. 271 

Asiatic, cholera is exclusively a contagious disease, brought on by 
germs mostly from Asia. Certain influences appear to increase the 
predisposition, when the disease is epideruib, to the severer form of 
the disease, or to diminish the resisting power of the organism to the 
action of the poison. Chief among these are errors in diet, emetics 
and laxatives, catching cold and other debilitating influencees. 

The cholera germ can only bepropogated if the system is succeptible, 
which is especially the case when one is afflicted with gastric or intes- 
tinal catarrh. In epidemics the general fear of contracting this fear- 
ful disease is already sufficient to cause disturbances in the nervous 
and digestive system to produce this catarrh. In such cases the dis- 
eased mucous membrane ; the badly digested nutriments in the stom- 
ach and intestines prepare the seeding ground for the germ and they 
multiply with indescribable rapidity. 

A person possessing a perfectly healthy digestive apparatus, which 
can perform its every day functions, need not fear tne cholera. Such a 
person is nearly impregnable. 

Symptoms. The first signs, which already need medical aid, are 
severe diarrhoea of a yellow, bad smelling mass, weakness, puffed up 
abdomen, pain, anxiety, dizziness. The diarrhoea then becomes watery, 
vomiting ensues, cramps in belly, and in the calves of the leges. 
The patient looses strength very rapidly. The evacuations of the 
bowels now becomes odorless, but contain the poisonous contagion. 
The skin becomes ice cold, if the skin is pulled, the folds remain, and 
they and the fingernails assume a dirty blue color. The countenance 
is deadlike, and shows much anxiety; the eyes become glassy; the 
voice hoarse; the internal heat of the patient is nearly unendurable 
and is unable to quench his thirst. Urinating stops entirely. The 
patient remains conscious during this attack and his mental and 
physical suffering is intense. 

If death does not occur during the height of this stage. Con- 
valescens ensues sooner or later. First the cramps in legs, then in 
the abdomen let up and gradually disappear, respiration becomes 
free pulse rises, the color of the skin becomes natural again and 
warmth of body returns, a warm perspiration breaks out all over the 
body, and the patient falls into a tranquil sleep from which he 
awakens, much refreshed. The first after this, he has intense desire 
to urinate and upon evacuating his bladder, the road to recovery has 
not many obstacles. The patient during convalescence must be 



272 TREATMENT. 

tremely careful, else a relapse might ensue in the chape of cholera,, 
from which he may die. 

Cholera terminates fatally in a great many cases, three, six or twelve 
hours after first symptoms become apparent, death often ensues. It is 
seldom that an attack is not definitely decided, one way or the other 
within two days. 

Treatment. Since there is more danger in a place, where cholera is 
prevalent, and still more in a house where it has broken out, than in 
other places, it is sensible for persons, who can make a long journey, 
without great inconveniences, to fly from the disease. Such persons 
should be sure to start on their journey soon enough; to go off as far 
as possible, and not to return till the last trace of the disease has dis- 
appeared. If you must stay at home, do not use any strange privy or 
one of your own, if you suspect that it has been used by a person 
liable to be affected already. Disinfecting privies does some good, 
but not sufficiently to rely on its non-contagious influence. People in 
cholera infected districts should be particular and careful about their 
diet, avoiding all food, known to them, to be hard to digest, or having 
a tendency to losen their bowels. Complete and sudden change of 
life is not advisable and while the extreme moderate use of red wines 
is not harmful, all other excesses in the shape of stimulants should 
be shunned. As soon as a patient is affected with diarrhoea, he 
should send for a physician, and remain in bed till the physician 
arrives, drinking in the meantime a few cups cf hot black coffee, made 
very strong, and also take some essence of Peppermint, Bottle No. 27, 
in teaspoonful doses in hot water. It is a well known fact that 
energetic sweating occasionally averts an attack of cholera. At least 
in every cholera epidemic, we see persons that have been attacked by 
copious diarrhoea, great debility, cramps in the legs, and even vomit- 
ing, and who, on account of these symptoms, have drunk large 
quantities of hot coffee, to which a liberal dose of brandy had'been 
added, buried in the bed clothes, and reeking with perspiration, while 
the passages which were often discolored and beginning to resemble 
rice, water discharges and the vomiting also have ceased. Experience 
also teaches that in such cases, if the sweating is stopped too soon, a 
true cholera attack not infrequently comes on, and that it is well not 
to let a cholera patient leave his bed till he has had a formed stool. 
We advise every one as soon as cholera becomes epidemic to purchase 
from any trustworthy druggist the following mixture: 



~~ 



DYSENTERY. 273 

R. Tmct. Valer. Aeth., two drachm. 

Vin. ipecac, one drachm. 
Tinct. opii., one scruple. 
01. menth. pip., five drops. 

M. S. Twenty to twenty-five drops every hour or two. Children 
over 12, fifteen drops, under that age five to eight drops. These are 
the celebrated Russian cholera drops, and have saved many a life. 
Use them as directed as soon as diarrhoea or any of the other sym- 
ptoms make their appearance, even before the physician arrives. 

Large quantities of warm drinks, are usually vomitted at once, dur- 
ing the height of the attack. When the patient suffers with torturing 
thirst allow him all the cold water, which had been previously boiled, 
he wishes. It will do no special harm. As soon as the pulse grows 
small and the patients are in an evident collapse, stimulants should be 
given from time to time, to prevent the paralibis of the heart. Rum 
or brandy diluted with half water is best for this purpose. Frictions 
of the skin with oil of mustard, Bottle No. 12, relieves the painful 
cramps in the muscles. Of course, nourishment cannot be given to 
cholera patients during the attack; but even after the attack is over 
and reaction has begun, you must be very careful about the food, and 
in order to protect the diseased intestines from in jury, nothing should 
be given, than diluted milk, meat broth without a vestige of fat and 
dipped toast. Solid food must not be given till pulpy and consistent, 
stools appear. Infringement on this rule is generally severely punished. 

Dysentery — Bloody Flux. It is a disease attended with inflammation 
and ulceration of the large intestine, and characterized by griping 
pain in the abdomen, constant desire to evacuate the bowels and the 
discharge of mucus and blood. When epidemic, it is contagious 
through the excrements. The germ, which originates the disease, 
flourishes outside of the human body and persons staying near its 
locality are in danger of being attacked by it. The circumstances 
favorable to the propagation of dystentery person are moist high 
temperature. It attacks in the open country oftener than the cities. 
Catching cold, getting wet, great fatigue, the use of unripe fruit or 
vegetables are causes of dysentery, in so far, that the injurious 
influences resulting therefrom, increase the predisposition to the disease. 

Symptoms. Dysentery begins with an apparently innocent diarrhoea, 
during which the faeces passed are not suspiciously looking, preceded 
by moderate colicky pains and accompanied by a feeling or desire to 
evacuate the bowels without the possibility of accomplishing the same. 



•274 DYSENTERY. 

This latter described feeling, called tenesmus, becomes very distress- 
ing and the cause of very much pain. When the evacuations occur, 
they are accompanied by a very torturing and painful bearing down of 
the rectum, to which is often added a painful discharge of urine. 
Immediately after an evacuation the patient feels relieved, and usually 
has pain only on hard pressure against the abdomen, especially in the 
region of the colon; but soon, even after a few minutes the torment- 
ation begins again, the patient writhes and groans, and, when the 
pains have attained the highest grade, tenesmus recommences, and 
again a small quantity of dysentery dejections of a sickening odor is 
passed. Sometimes this scene is repeated twenty or thirty times in 
twenty-four hours. There is always more or less fever. Convalescence 
is very slow. 

If the disease passes from the acute to the chronic form, as is very 
often the case, the fever disappears and the intestines become ulcerated. 
Diarrhoea generally alternates with constipation, occasional normal 
faeces, with bloody masses clinging to them, at other times a fluid 
from the ulcerating mucous membrane is evacuated. The patients be- 
come very much emaciated, and after languishing for months usually 
die of dropsy. Should, however, the intestines heal, dysentery is 
followed by stricture of the intestine. For the rest of his life, the 
patient suffers from habitual constipation and the various inconveni- 
ences incident thereto. 

Treatment* Avoid the causes of this disease and thus prevent its 
occurrence, especially do not use a privy, which has been used by 
persons afflicted with the malady. 

In milder cases of dysentery it is well to begin the treatment with 
medium doses of castor oil and apply very warm poultices of corn or 
linseed meal to the abdomen, keeping it up till the pains are relieved. 
Even in the mildest grades of dysentery, the patient should keep care- 
fully in bed, and eat nothing solid, but live on soup diet. If the 
patient be strong and full blooded, watersoups of toast or parched 
flour will do, but if he be weak and poor in blood, you must attend to 
keeping up his strength from the beginning and give concentrated 
meat broth, raw eggs, farina, and other soups of like character. In 
aggravated cases, keep up the practice of giving castor oil in table- 
spoonful doses every four hours, and give injections made as follows: 
Take common cornstarch, one tablespoonful, and add to it one cup 
cold water and stir well, have the substance in a large bowl and add 



SYPHILIS. 275 

to it about one-half pint boiling water, stirring constantly, when luke 
warm yet inject bv means of syringe into rectum, the whole quantity 
should be used at one time. If the pain is very intense, to this 
emulsion 10 drops laudanum may be added. This injection should be 
made every 3 to 4 hours, unless sooner relieved, and patient should 
be advised to keep the mass in his rectum as long as possible before 
evacuating same. 

Trichinae Disease or Trichinosis, is exclusively caused by eating raw 
or only partially cooked pork, by means of which the trichinae are 
transferred to the human body, first of course, to the intestine and 
from there to the muscles. Not all pork contain trichinae, but 
presumably from those hcgs, which have been feasting on dead or 
live rats. It is a well known fact that rats not only frequently have 
trichinae, but that they often die from the effects of them. How they 
get into the rats is not known. 

As prevention is better than a cure, take the advice and abstain 
from raw pork in any shape, or even that which has only been paati- 
ally boiled, baked, wasted or broiled. If pork is well and thoroughly 
cooked, the trichinae is destroyed. Pork under all circumstances 
should be extremely well done. 

Syphilis appears in various forms. 

1. Chaucre, belongs to the class of purely contagious diseases, 
and no one contracts it, who has not been infected with the virus of 
the opposite sex. 

2. Glandular chaucre or bubo belongs to the secondary stages of 
syphilis and is the neglected product of the first. 

3. Constitutional'syphilis, is when the disease in its primary stage 
has been so neglected as to poison the whole system. 

Hereditary Syphilis, is that form of the malady occurring in newly 
born children, and originating in the embryo, from constitutional 
disease existing in the father at the time of begetting the child, or in 
the mother during pregnancy. If a woman, who has secondary 
syphilis becomes pregnant, the foetus nearly always dies premature 
and is expelled by a miscarriage. 

Inasmuch as this disease should never occur in a family, for which 
this work is intended, it is believed to be out of place to give room in 
it for its discussion. However, it is hoped, that fathers and mothers 
should make careful inquiries before they consent to the marriage of 
their daughters, whether their future son-in-law is or has been afflicted 



276 HYDBOPHOBIA. 

with this loathsome disease. It would be -well for themselves and 
also for the happiness of their child to refuse consent to a union, with 
a man, who is, or has been recently troubled with this nasty malady. 
Should, however, any man or woman have contracted syphilis, they 
should not wait till it becomes secondary or even tertiery in its nature, 
before consulting their regular family physician with a view to under- 
go a radical cure. If the disease is allowed to run along and is not 
checked in proper time, it is next too impossible to entirely eradicate 
it from the system. 

Hydrophobia — Rabies,is a disease resulting from the bite of a mad or 
rabid dog, or from its licking a wounded portion of the skin. Bites of 
rabid animals upon bare portions of the body are far more dangerous, 
than if the part bitten be covered by the clothing; as in the latter 
case, the poisonous saliva is not so readily conveyed to the wound. 

Symptoms. The shortest term of incubation appears to be about 
eight or ten days, the longest twelve to thirteen months. In the 
majority of instances, the malady breaks out in about forty days after 
the reception of the bite. 

The first stage of the disease is marked by a peculiar depression of 
the patient's spirit, amounting to an acute melancholia. The patient 
seeks solitude, is timid and apprehensive, and either sits motionless 
and plunged in deep abstraction, or else is unable to rest at all. 
Sleep is restless and broken by frightful dreams. The spasmodic 
breathing is the first token of the tonic spasm of the muscles of inspir- 
ation which causes such frightful torments in the second stage of the 
disease. The first stage having lasted two or three days, the second 
or furious stage begins. Its onset is marked by a fit of choking, sud- 
denly induced by an attempt to drink, which renders the patient 
incapable to swallow a drop. The dread of water is entirely due to 
the dreadful experience of the patient on trying to drink. Exhibition 
of water or even of drinking vessels, usually throws the patient into 
convulsions. 

These symptoms are soon accompanied by attacks of boundless rage, 
in which the patients are hard to manage, destroy all that comes in 
their way, strike, kick, scratch, and bite, if held fast, and not unfre- 
quently kill themselves if not held fast. Very often, between fits, 
which usually do not last longer than one-quarter to half an hour, the 
patient warns his attendant, and asks pardon for his misbehavior, and 
sets his worldly affairs in order, in perfect consciousness of the near 



CHLOROSIS. 277 

approach of his end. The fits of madness and convulsions, having 
steadily grown more frequent for two or three days, begin to diminish 
in violence aud duration, as the patient loses strength. The exhaus- 
tion and collapse usually augment from hour to hour, the voice grows 
hoarse and feeble, and death relieves the sufferer. 

Treatment. The only prevention is by confinement of dogs. No 
attention should be paid to the lovers of dogs. Any one, who expends 
sympathy on the " poor dog," and petitions against his being tied up 
or muzzled, should be made to watch a patient with hydrophobia for 
half an hour, and he would soon be cured. Many of the muzzles that 
are placed upon dogs do not prevent their biting, and they are only 
protective when they do so. 

Unless the inoculation after the Pasteur method is resorted to as 
soon as possible, little hope can be extended to the unfortunate, who 
has been bitten by a rabid dog. 

If the disease has broken out there is no hope of curing it, or even 
of alleviating the sufferings of the patient. No observation is on 
record of any well authenticated case of hydrophobia, which has ter- 
minated otherwise than a very painful death. 

Even the waiting upon and nursing of the patient are very difficult, 
and should only be trusted to persons who are humane as well as 
fearless and energetic. Every thing that can produce fits of madness, 
such as the exhibition of water should be strictly avoided. 

The physician in charge of the case will always find some means to 
shorten the fits and perhaps incident to it the terrible suffering of the 
patient. 

Chlorosis or green sickness. This is one of the most common of dis- 
orders in females between the ages of fourteen and twenty-four, and 
is doubtless ascribable to the effect of those processes which are 
going on in the bodies of young girls at the period of puberty. The 
development of this affection is encouraged by want of fresh air and 
exercise by improper nourishment, mental excitement, improper 
reading, masturbation, or by a general unhealthy mode of life. 
Obstinate chlorosis attacks all young girls without exception in whom 
the menses have appeared in the twelfth or thirteenth year, and 
before the development of the breast. 

In pronounced chlorosis, the disease of the red blood corpuscles is 
very prominent, and the proportion of corpuscles greatly diminished. 



278 {SYMPTOMS. 

Symptoms. The most striking symptom of chlorosis, consists in tne 
paltor of the skin and visible mucous membrane. In blondes the 
surface is of a pure white, and in dark haired persons it is more of a 
dirty grey or yellowish hue. The palor is often most distinctly pro- 
nounced upon the ears, while in the mucous membranes the loss of 
color is most pronounced in the lips and gums. The reason for this 
blanching of the complexion is manifest. The number of red corpus- 
cles upon the blood itself depends for its redness and the tissues 
through which it circulates for their tints is reduced one-half, one- 
third or even lower. 

Chlorosis is always accompanied by more or less shortness of breath 
owing to a diminuation in the number of corpuscles, which in their 
function take up oxygen and carry off carbonic acid. The normal 
number of respiratory acts is insufficient to supply oxygen to the lungs 
in quantity adequate to the wants of the system. It is for this reason 
that patients with chlorosis scarcely ever fail to complain that they 
get out of breath when they walk fast or mount the stairs. The 
strength of the muscles, which to be vigorous calls for a supply of well 
oxygenated blood, is greatly reduced. The patient is easily fatigued 
and complains of a sense of weight in the limbs. There are usually 
signs of hysteria in persons afflicted with chlorosis, also a troubled, 
irritable temper, disposition to weep and a perverted appetite. 

The patient usually always complain of palpitation of the heart, be- 
sides which other serious disorders of the digestive system arise in 
cholorsis, which must be carefully looked after. The appetite is near- 
ly always diminished, and after eating there is a sense of fullness and 
pressure in the stomach with sour eructations and symptoms of dys- 
pepsia. These troubles are not dangerous at all if properly looked 
after. The urine of the patient is nearly water white. There is also 
more or less trouble about the sexual organs, about the time of 
menstruation, and it is not unfrequent that the menses are from a 
week to ten days late. In some girls the disease is aggravated by 
catarrh of the womb and vagina. 

The course of chlorosis, unless cut short by proper medicine, i» 
always slow and tedious, but usually terminates in complete 
recover, although in many young persons one or two relapses may 
occur. 

Treatment. As soon as the fact has been well established that a 
a young girl is afflicted with chlorosis, administer to her after each 



Hl*f 



SCROFULA. 279 

ineal three times a day, two of Bland's Feruginous pills, bottle No. 
18, and if the pills are well borne on the stomach, which they usually 
are, increase after first week the dose to three pills three times a day. 
This remedy is a specific and while slow is a sure cure. 

Of course the diet of the patient must be looked after, and good 
healthy food should be the rule ; avoid pies and pastry as much as 
possible. If constipated administer an injection of lukewarm water. 

Chlorotic patients are languid, indisposed to exertion, and void of 
appetite. This is the nature of the disease. Do not force them to 
exercise or walk, but make them promise that they will do so as soon 
as their strength is sufficiently established. As soon as the medicine 
prescribed shows its restorative power the desire to get out of doors 
will show itself and with it returns the lost appetite. 

Relapses cannot be averted, especially when it sets in first at 
commencement of puberty, but is easily cured by resorting again to 
the above mentioned medicine. 

Under no circumstances allow your patient too much acid, such as 
vinegar in food and also be sparing with fresh fruit. 

Scrofula. The name of this disease signifies a morbid condition of 
of the system, manifested by a remarkable liability to certain forms 
of disorders of the skin, mucous membranes, joints, bones, organs of 
special sense, and above all, the lympathatic glands. A person hav- 
ing merely a tendency to such disease is what is usually termed scrof- 
ulous. 

It is of rare occurrence that this disease is acquired after birth. Its 
main origin is of a complicated nature. It is particularly from off- 
spring of scrofulous parents, and of such it is common that all their 
children inherit the trouble. Parents who are consumptive at time of 
begetting the child, either collective or single, or if either one of them 
suffer at the time of copulation from cancer, syphilis, or of parents 
beyond a certain age, are well-known causes to incubate into their 
offspring this disease. It is also well known that many of the mental 
and bodily traits of parents are transmitted to their progeny, it will not 
seem extraordinary that children of feeble, sickly fathers and mothers 
should have a greater tendency to disease than those whose progena- 
tors are vigorous and healthy ; but science is totally unable to account 
for the fact that scrofula is very prevalent in the children of parents 
who are too closely related to one another by blood. 



280 SCROFULA. 

Acquired scrofula generally arises as a result of pernicious influen- 
ces, which have impeded the healthy development of the system during 
the first years of life. First of all among these stands improper nour- 
ishment, a course diet, containing but little nutriment in comparison 
with its bulk, being very properly held in especially evil repute. The 
earlier this injudicious feeding of an infant commences, so much the 
greater is the danger that it will become scrofulous, hence the children 
fed on pap furnish a very important contingent to the army of scrofu- 
lous persons. Want of fresh air and exercise exerts an influence as 
baneful as that of improper food. 

Symptoms. The so-called scrofulous habit is marked by a deficiency 
of blood and by a bad nutritive state of more important tissues, and 
sometimes accumulation of fat in certain regions, especially in the 
upper lips and nose. 

Scrofula, although principally a disease of childhood, rarely declares 
itself in the first years of infancy, exerts through a few faint tokens. 
At the time of puberty scrofulous diseases usually subside and with 
them the scrofulous habit more or less completely disappears. How- 
ever children having it in the system, and it does not come out during 
childhood, are usually attacked by it later in life. Skin and scalp 
eruptions, the former mostly on the face, are the commonest forms. 
The distructive affections of the skin, however, come usually later in 
life. 

Scrofulous inflammation of the mucous membrane is most apt to 
appear in the vicinity of the natural orifice of the body, when it then 
readily implicates the neighboring skin. 

Scrofula exerts its debilitating influences all over the body, and 
among the organs of special sense. The eyes, and more particularly 
the lids and tear glands are affected by obstinate inflammation. In 
the ear, besides the inflammation of the external auditory canal it 
inflicts damages to the bones of the ears and causes difficulty in hear- 
ing and even deafness. 

The progress of scrofula is tedious and treacherous and nearly 
always is marked by periodical alternations of improvement and aggra- 
vation. Either the same symptoms re-occur again with renewed 
severity or else the former set having abated, or subsided new ones 
arise. Complete recovery from scrofula is a very rommon occurrence. 

Death rarely results from the disease itself, but many children 
die of croup, water head, colic and other diseases of childhood, having 



DIABETES. 281 

through the debilitating tendencies of scrofula, a predisposition to 
contract these maladies. 

Scrofula of long standing and which has not received any care 
whatever, may form into consumption. 

Treatment. Prevention against heriditary scrofula lies beyond the 
sphere of the physician, unless that scrofulous, consumptive, sickly 
and superanuated persons should not marry at all and that healthy 
and vigorous persons should not wed their near relatives. Such 
advice from a friendly physician, however, is usually rewarded by 
loosing a customer. Scrofulous children, in addition to weakness and 
a puny state, should have plenty of fresh air and muscular exercise, 
even if they have to be kept from school and allowed to romp around 
in the open air. They should be given a plain, healthy and easily 
digestible diet in which animal food predominates. Potatoes, vegeta- 
bles of a like character and butter should only be allowed in modera- 
tion. They should be given a salt brine bath every morning, or at 
least sponged with strong salt water. In very decided cases give 
cod liver oil, commencing in teaspoonful doses and gradually increas- 
ing. 

Children in the first year of life must not be given any pap or other 
artificial food, but nothing but mother's milk. Should the mother 
not be able to supply the wants and circumstances permit, employ a 
healthy wet nurse. After the child is weaned, do not over feed but be 
regular and commence at an early day with meat broth, beaten eggs 
and plenty of fresh cows milk. 

When scrofulous children get to be about three years old, coffee 
made of acorns is of the utmost benefit to them, and can be given to 
them at all meals instead of the regular beverage. Gather in fall the 
green acorns, dry them in oven, remove the shell, parch the meat of 
the acorn, same as coffee, grind and prepare, using with it a little 
sugar and milk. Under the above dietic treatment scrofulous chil- 
around to lasting health in nearly all cases, and the traces of the 
disease dies out. 

The freqent bathing of scrofulous children in cold water cannot be 
too strongly recommended. 

Diabetes or sugar disease occurs about three to one in males and is a 
rare disease during childhood and old age and often depends upon 
heriditary predisposition. The exciting causes to this disease are 
exposure to cold and wet external violence, immoderate eating of 



282 TREATMENT. 

sugar, drinking new wine, unfermented juice of fruit, indulgence in 
immoderate mental exertion, mental depression, and, above all, 
intoxication. 

Symptoms. The most remarkable symptom of sweet diabetes con- 
sists in the evacuation of enormous quanties of urine nearly colorless 
and of a sweetish taste. It is by no means rare for a diabetic patient 
in the course of twenty-four hours to pass from five to ten quarts of 
urine, and in some cases the discharge has been much larger. 

Owing to the excessive loss of water through the kidneys the patient 
experiences an unquenchable and parching thirst, both day and 
night. Also through this enormous flow of water in one direction* 
perspiration is completely arrested, An unsatisfiable hunger is a symp- 
tom of diabetes ; quite as constant as is the unquenchable thirst. It is 
almost incredible how much food such a patient will consume during a 
day, often quite regardless of quality. 

Men suffering with this disease are always impotent, owing to the 
general decline of strength. The course of diabetes is always chronic 
lasting for months and years. A complete and permanent recovery 
from diabetes is extremely raie. Death, when not the result of some 
complication, usually takes place with the signs of extreme wasting 
away of flesh. Towards the end nervous complications usually make 
their appearance. 

Treatment. Numerous remedies and cures have been recommended 
for diabetes, but, unfortunately, most of them have been devised 
upon principles based on theories, which are not borne out by facts. 
Experience has established the fact that if certain rules of diet are 
observed, the life of a patient can be indefinitely prolonged even if his 
malady cannot be cured. It is of the utmost importance that the 
patient should live principally upon animal food, and that they should 
eat but little of starchy or sacchariae matter. Besides the meat the 
patient can eat such vegetables as do not contain sugar or starch, or 
but very little of them. From the following articles it is presumed a 
variable and acceptable bill of fare can be selected without tiring the 
patient with too much sameness. All sorts of roasted, boiled or 
stewed meat dressed with spices, but not with flour, fresh and salt 
fish, oysters, clams, lobster, eggs in all forms, rich, good cream but 
no skimmed milk. In the line of vegetables the following may be 
used: Spanish artichokes, asparagrus, green beans, cabbage of all 
kinds, lettuce, water-cresses and celery. Of fruits strawberries and 



TREATMENT. 283 

peaches. Bread, or anything made of flour, sugar in all its forms and 
shapes, alcoholic beveraves, beets, turnips, potatoes, peas, dried beans, 
squash and vegetables of like nature must be strictly avoided. If the 
patient cannot do without bread, allow him at every other meal a 
small piece of stale graham bread, which has been made without 
sugar, and in which the bran predominates about three to one. The 
patient should not be allowed any more liquid than is necessary to 
slacken his thirst for which spring water is of course the best; there 
may, however, be made additions to it of a little lemon juice. Coffee, 
if taken without sugar, can be used. 

Diabetic persons are very liable to take cold and show a predisposi- 
tion to pneumonia, and for this reason should all such patients wear 
flannel next to the skin and woolen stockings. Of all medicines tried 
none deviates the patient as much as bi- carbonate of soda, bottle No. 
4, and it is advisable to take of it three times a day after each meal, 
about a quarter teaspoonful of it in a half table spoonful of water. 



Surgery. 

WOUNDS. 

IN all classes of wounds the main point to observe is the thorough 
cleansing and disinfecting of the injured place, and to bring the 
lapses together until granulation sets in. If you succeed in this 
no fear need be entertained about wound fever or troublesome suppu- 
ration. 

The form of the wounds being of such wide range it would be im- 
possible to decide how to proceed in the matter, inasmuch as the 
dissimilarity is too extensive. 

Of all the accidents, which cause wounds, cuts are the easiest to 
heal, provided the cut is with the grain of the muscular fibres. Bruises 
are of much difficulty. Stabs with a knife or other penetrating 
weapon, become dangerous, if penetration into the vital organs has 
been made and are hard to clean and to disinfect. Gunshot wounds are 
perhaps the most difficult wounds to treat, especially so if the ball has 
taken in its course, fragments of cloth or particles of the lead were 
loosened, and deposited these foreign substances along the course of 
the missile. Furthermore, the ball bruises and burns the tissues to 
some extent along its track. 

In wounds where haemorrhages are, it is of the utmost importance 
to stop these. If the bleeding is not excessive and apparently only 
from the capillaries the washing with very cold water will usually 
stop the flow. Bleeding from the veins is recognized by the dark color 
of the blood and by its steady flow and with very little force. By ap- 
plying a rather tight bandage, such as can be made with a handker- 
chief or suspender usually stops the flow of venous blood. This 
bandage should be applied beneath the wound, if below the regions of 



BLEEDING OF THE ARTERIES. 285 

the heart and above the wound, when on parts of body lying above the 
heart. The veins having niiuy interchanging channels, soon finds 
other passages for the flow of the blood. The bandage should be so 
applied that it also causes some little pressure upon the wound itself. 
The pressure of the blood in the veins is not a strong one, but in 
wounds on neck, where veins are cut, or otherwise opened, it is well 
to close them as soon as possible, for the reason, that the entrance of 
airiu these bloodvessels in this part of the body is very dangerous* 

Haemorrhages from the arteries, requires surgical aid, in order to stop 
the recurrence. An artery of the neck, if cut, will squirt the blood 
for a distance of ten feet and in the forearm nearly an equal distance. 

This shows, with what enormous force the heart pumps the blood 
to all parts of the body. The blood of the arteries is of a bright red 
color and can be easily recognized by it, as well as by the force, with 
which it is propelled. 

In accidents where arteries are cut or opened, so that blood is 
emitted from a wound, the first aim should be to save as much as pos- 
sible of this life giving fluid. Through this spurting of the blood, the 
application of temporary bandages is somewhat difficult, and even 
before it is done, the thumb or index finger, should be pressed against 
the artery emitting the blood. As soon thereafter, an application 'of a 
temporary bandage should be made, with sufficient force, so as to com- 
press the artery emitting the blood. If the wound is in the 
upper arm, it is also well to make a ball of a handker-chief or 
other piece of cloth and put it into the armpit, pressing or 
binding the arm as tight as possible against chest. Same procedure 
might be followed if the wound is in the leg or foot, bend the knee 
and place at knee joint a pad, similar to one described for armpit. 
Thus you will stop the flow of the blood easily and when the surgeon 
arrives, will properly ligature the ruptured arteries. Wound on head 
where arteries are damaged, press forcibly against. Haemorrhages on 
neck and chest are hard to stop. If a small wound, press same with 
finger, if large one fill the same with linen lint. In cases of all 
wounds, which bleed profusely, the patient should at once assume a 
horizontal position. Under no circumstances allow any wine, beer or 
liquor to the patient. Keep the patient rather warm, except at wound, 
where, with cold compresses, the temperature can be kept down. 

The cleaning and disinfecting of the wound is of the utmost impor- 
tance. The weapon with which the wound was made, often carries 
foreign substances to the tissue, which if not promptly removed, will 



286 FKOST BITES. 

cause suppuration. Often dust enters the wound, if the same is in 
the vicinity of the hair, consequently the surrounding of the wound 
should be clearly shown. For disinfection and washing of wound, 
take water, which is not too cold, and add to it, say, one teaspooful 
Carbolic Acid 10% C. P., Bottle No. 5, to a tumbler full of water, 
using for its application a very clean and soft sponge or clean linen 
rag. If the wound overlaps, fit the skin to a nicety, lay over it a 
nice layer of clean linen saturated with the above described carbolic 
water, over that some cotton batting. This bandage should, at least, 
extend 2 inches beyond the wound proper, then tie the whole with a 
clean cloth or gauze firm, but not too tight, so as to obstruct a free 
circulation. All wounded persons need perfect rest. Persons wounded 
in leg, should keep the bed, elevating the wounded member some- 
what. Wounded arms should be carried in a sling, suspended from 
neck. 

"Wounds of some of the main arteries, should be entirely under con- 
trol of the surgeon, and you should pay particular attention, how he 
does it, so that you can do it next time and save expenses. In all 
sorts of wounds, when you notice that the bandage shows unhealthy 
matter or dirt, the wound must be cleaned at once and new bandage 
applied. Further, as soon as the patient complains of heavy pain, 
shows symptoms of fever, swelling of surrounding, it is only a sym- 
ptom that the wound is not clean. As soon as you attend to it, these 
symptoms will vanish. Plasters, salves, ointment and other advertised 
remedies are of little or no avail and generally make the wound worse, 
by inducing suppuration. 

Frost-bites mostly take place on exposed and thin appendages of the 
body. Toes, fingers, ears, nose and cheeks. Through cold the 
affected part first becomes blue and benumbed; and shortly after that 
entirely insensible to touch. Frost bitten parts should be at once 
covered with snow or very finely shaved ice, until redness and sensi- 
bility returns to skin. Warmth must be strictly avoided, as it would 
cause a flow of blood to the affected parts in such quantities as to 
cause inflammation of a serious nature. Prevention against frost-bite 
is the rubbing of the exposed parts with vaseline , Bottle No. 14, before 
going out. 

Itching often appears on parts of body, which have been frost- 
bitten. To alleviate and effectively cure this make a solution of 
Alum, Bottle No. 1, and bathe afflicted parts, and allow the moisture 



- ; - --• — ^-^— ■ -^ _^^^^*. . 



BUBNS AND SCALDS. 287 

to dry before a stove or open fire. Two or three applications will 
bring the desired relief. 

Burns and scalds. In minor accidents of this kind, apply at once 
Bi-carbonate of soda, Bottle No. 4, dry, and over it lay a rag, which 
is saturated with a little vaseline, Bottle No. 4. Wrap the burned or 
scalded part, and keep quiet. This remedy is infallible and at once 
deadens the pain. In case clothing has caught fire, throw yourself 
down and roll around in order to extinguish flame. If bystanders 
are arc und let them procure at once a sheet, blanket or quilt, throw 
patient and cover him in blanket or quilt. Throw water on burned 
or burning places. Wounds from excessive burns or scalds are 
dangerous to life. Before you can get the physician, place patient in 
bath of pretty warm water, you can keep the sufferer for an indefinite 
length of time. Give very hot coffee or tea in tablespoonful doses to 
keep up the warmth of the body, which usually sinks rapidly in case 
of severe burns. The physician will, according to circumstances, ap- 
ply bandages, after which, if you pay atteution to the procedure, you 
can do it yourself. 

Bruises or contussions, are injuries attended with more or less dis- 
organizations of the tissues beneath the skin and of effusion of blood 
under the same without breaking it. 

If the injury is in the muscular part apply hot compresses to the 
part for fifteen to twenty minutes, after which apply a solution of 
Arnica, Bottle No. 2, two teaspoonfuls to a cup of warm water, 
saturate rag and apply continuously till pain and swelling abates. 

In injuries about the eyes, arnica should not be used, applying hot 
water solely and in aggravated cases using a piece of lean raw beef. 

If the bruises affect the vital organs, such as lungs, liver, stomach, 
spleen, etc., or even the fracture of ribs, surgical aid is necessary, as 
these internal injuries are of great danger to life. Till the surgeon 
arrives, keep the patient as quiet as possible, to avoid internal bleed- 
ing, which is more liable to result, when the patient is not kept quiet. 

Shocks are sudden depressions of the vital forces of the entire body 
or a part of it, marking some profound impression produced upon the 
nervous system, as by severe injury, overpowering emotion or the like. 

In cases of severe shocks, the heart's action are hardly perceptible, 
pulse weak, skin pale, cold and insensible. Consciousness is not 
entirely absent. 

Treatment. Place patient in a recumbent position head down, allow 



288 DISLOCATION OF JOINTS. 

him to smell on camphor, Bottle No. 8, in severe cases, and when 
collapse is feared, give the strongest kind of hot coffee without sugar 
or milk. Wrap patient in warm blankets and put hot bottle, or hot 
earthen dishpan to his feet. Do not move patient till completely 
restored. You can also give 15 drops Hoffman's Anodyne, Bottle No. 
25, in water. 

Sprains, are the effects of straining the muscles, ligaments, tendons, 
etc., producing swelling, soreness, pain, and disabling the joint for 
use. 

Treatment. Take of Arnica, Bottle No. 2, and dilute with water, 
using 1 part Arnica to 3 of water, apply to injured part by means of 
rag saturated in the remedy. Quietness is essential to a cure. 

Dislocation of Joints. In order to avoid a stiff joint for life, the 
resetting of the same should be left to a good surgeon. Till the arrival 
of the professional man, the afflicted member should be placed in a 
position, which insures quietness and amelioration of pain; apply 
cold compresses to the dislocated joint, to check the internal bleeding. 
After resetting of the joint by the surgeon, the patient must keep 
entirely from any motion, especially till he is assured that the cartilages 
have properly healed. After the bandages have been removed, the 
movements must be very passive at first, increasing in graduation, as 
the joint gains strength. 

Dislocation of the shoulder joint. Nearly fifty per cent, of all dis- 
locations aie at this point, when the head of the humeris leaves the 
socket of the shoulder blade, and lodges under the collar bone. After 
setting the joint by the surgeon, two weeks' rest are needed befere 
passive movements are permissible. Dislocation at elbow and wrist 
are often connected with fractures of the bones. 

In all dislocations of the joints at upper extremities carry arm in 
suspensory. 

Dislocations of the hip joint happen seldom, it requiring very much 
strain to effect it. In case it happens, the bed is the proper place 
and should not even move to urinate or for evacuation of the bowels. 
The urine bottle and bed pan must be used, to prevent unnecessary 
movement. 

Dislocation of knee and ankle joints are of rare occurrence, they re- 
quire surgical aid and much rest. 

Fractures of bones occur mostly at the extremities and ribs. As 
soon as a fracture has taken place all movements of the injured parts 



FRACTURES OF BONES. 289' 

must cease. It should be set by a competent surgeon as soon as pos- 
sible. He will also give directions, according to circumstances, what 
position to assume. If possible the setting of the fractured bone 
should take place when the mishap happened, before he is transferred 
to his home or hospital. 

The first thing to do in case of accident, where fracture of the bone 
is suspected, is the removal of the clothes and especially of the shoe 
or boot, not by pulling them off, however, but by cutting open the 
seams. Then place the patient in a comfortable position and apply 
cold water compresses to keep the swelling down. Do not touch 
unnecessarily the affected member. When the surgeon arrives, do 
not act stupidly but assist him all you can by energetic action. In 
fractures of the leg, the limb is best placed in plaster paris, which will 
take away nearly all pain. In transporting patients with fractured 
bones of the leg, a stretcher should be used, which ought to be carried 
by strong men, if a spring wagon or ambulance cannot be had. 

Fractures of bones are dangerous to life, if inflammation sets in, 
hence the strict obedience to the surgeon's directions are necessary. 

In case of accident to legs where fracture has happened, and the 
surgeon cannot at once attend to the setting and bandage on the spot, 
and when it becomes a case of necessity to remove patient, as in case 
of inclement weather, do not do so till you apply a temporary bandage 
by means of splints and handkerchiefs. Under no circumstances re- 
move the patient till the wounded leg has this support. 

MISCELLANEOUS INCONVENIENCES. 

Freckles. Apply lemon juice diluted with pure water, three times 
a day. 

Gumboil. Roast a dryed fig and apply, keep it there till the boil 
opens. 

Boils and Carbuncles. Poultice with linseed meal till it opens, when 
all matter has been discharged wash the wound with a solution of 
carbolic acid C. P., 10%, bottle No. 5, one part acid to four of water. 

Itching at Vagina and anus. Wash the parts five or six times in 
luke warm water and castile soap, dry thoroughly and dissolve one 
teaspoonful of borax, Bottle No. 3, in one glass water, of solution ap- 
ply to afflicted parts, with a clean sponge after each washing. 

Proud flesh. In minor wounds, which are slow in healing, proud 
flesh often makes its appearance. Wash thoroughly in luke warm 



290 FAINTING. 

water and castile soap, dry, and apply rag saturated with carbolic acid 
10% C. P., Bottle No. 5. 

Swoons and Fainting. Let patient smell at camphor, Bottle No. 8, 
and in severe cases loosen all clothes, especially the corset and apply 
hot compresses to chest. Wash head with cold water where pulse 
has become feeble, administer a tablespoonful of whiskey of brandy. 
The latter should, however, be only applied in very severe cases 
where the other remedies prove of no avail. 



— •--- 



Reproduction. 

PREGNANCY. 

1 I J HE male and female organs of generation, as well as their secre- 

I tions have heretofore been described. Human generation is 
accomplished by the union of the sexes. The female organs 
produce the ovum or egg, which is conducted into the womb by way 
of oviducts, where, during copulation it becomes fecundated by means 
of the semen, injected into it by the male. The female organs pro- 
ducing these ovum or eggs are the ovaries. The male organs giving 
rise to the semen or spermatic fluid, are the testicles. When an 
ovum, in the course of nature, has found its way into the womb, and 
there has come in contact with the semen of the male, and the ovum 
has thus become fecundated, a woman conceives. From this period 
her pregnancy dates. 

If the ovum remains unfecundated, it is expelled from the womb, 
including the blood and membranes which had formed there for its 
propagation. This expulsion from the womb constitutes the monthly 
bleeding, also called period, menses, or menstruation. Conception 
in woman is possible as long as these regular periods occur; they cease, 
however, between the ages of forty-two and fifty years. 

All causes of ill health which derange menstruation are also apt to 
interfere with pregnancy, and women whose menses are regular are 
more likely to become pregnant after sexual intercourse than those in 
whom the periods are temporarily absent or irregular. 

When pregnancy takes place, however, the menses are suspended 
during its continuance. They usually remain absent after delivery 
until the end of lactation, when they re-commence and re-occur at in- 
tervals as before. 

Sexual intercourse is most liable to be followed by pregnancy when 



292 MORNING SICKNESS. 

occurring soon after the menstrual period. Before its discharge, the- 
egg is immature and unfit for impregnation and some days afterward 
it looses its freshness and vitality. The exact length of time preced- 
ing and following the menses, during which impregnation is possible, 
cannot be ascertained. 

Pregnancy is recognized by various symptoms. Absence of men- 
struation is usually one of the first ones, especially so when the lady 
is in the enjoyment of full health. This symptom, however, 
is by no means conclusive, as these monthly periods are often inter- 
fered with otherwise, as heretofore described. If the absence of the 
menses are accompanied by other symptoms, it may be considered as 
a sign that the lady has ascended the first step towards motherhood. 

Morning sickness appears generally within three to five weeks after 
conception. Sometimes, however, within a few days after, women 
during this stage suffer more or less from nausea, vomiting and gener- 
al languid feeling, which is caused through intimate connections of 
the nerves throughout the body, and in consequence of the disturban- 
ces which are taking place, hence the sympathetic action of the stom- 
ach. This malady is sometimes quite distressing, but to use medi- 
cines would do no good whatever. When afflicted with it, women 
should eat as much fruit as posssble and other articles of food which 
they know are easily digested by them. 

When the digestion is good, tongue clear and no apparent cause 
otherwise of the bad feeling in the morning, when the first attempt to 
arise is made, the morning sickness in connection with the previous 
one, is an important link in that chain of evidence which indicates 
the pregnant condition. In some women this morning sickness does 
not appear at all. 

Enlargement of the breasts. Usually within five to eight weeks after 
conception, often even earlier, there occurs a sensation of fulness, 
with throbbing and peculiar pain in the throat, and begin to be en- 
larged. Their size increases materially ; to the touch they appear 
firmer and in the beginning of the change somewhat knotty. If this 
enlargement of the breast is caused by deposit of fat, the balance of 
the body would likely receive proportionate fatty increase. Hence 
when the develodment of the breast under presumable circumstances 
takes place, it is a sign, in connection with the other symptoms, of a 
pregnant state. 

Darkening of the areola around the nipples. The color of the nipple 






ABDOMINAL ENLARGEMENT. 293 

and areola of the virgin is usually but a shade oi two deeper than that 
of the skin; but in about seven to eight weeks after conception, the 
circle, usually of a pinky color, around the nipples becomes several 
shades darker, and increases in extent and in depth of color as preg- 
nancy progresses. This is usually only available as a symptom in 
the first pregnancy, and nearly an infallible one. In subsequent 
pregnancies it is of no value, as the color of the ring surrounding 
nipple remains As the discoloration of the areola progresses, the 
nipples and surroundings become swollen puffy and somewhat moist. 
The veins beneath the skin of the breasts become visible. 

Abdominal enlargement. It is caused through the gradual enlarge- 
ment of the womb, in which the foetus grows, and unless some 
abdominal disease exists, is a very apt sign. 

Quickening is the first motion of the foetus in the womb felt by the 
mother, occuring about the middle of the term of pregnancy. Especi- 
ally when these movements are felt by another person, it may be 
regarded as an infallible sign of pregnancy, and if, till the date of the 
perception, any doubt has been entertained, four and one-half months 
may be reckoned till commencement of labor. 

Physical diagnosis as to pregnancy, if further doubt exists, is better 
left to a physician, whose practical eye and touch will, with little 
trouble, demonstrate the true state of affairs. A very queer phenomena 
is often seen in hysterical women, who imagine themselves pregnant, 
and are not, in reality; their imagination carries them so far, that 
they have the morning sickness, about the tenth week feel the womb 
in the shape of a hardened ball in the vicinity of the pubis, in the 
fifteenth week, the ascension of the womb, halfway up to the navel, 
and in the twenty-second week right back of it, so that its depression 
is nearly obliterated. And all this trouble and anxiety for nothing 
and doomed in disappointment. 

Birth may be expected, if you know the date of last menstruation, 
add to it seven days, and from product substract three months. For 
instance, if your last menses occurred on January 1st, add seven days, 
which would be January 8th. Three months taken from it, brings 
the approximate day of birth to October 8, coming. 

As soon as labor commences, the doctor, or midwife, who should 
have been forewarned in time, should be brought to the chamber, 
where confinement is to take place, and besides the professional man 



291 BED LABOE. 

or woman, and perhaps one nurse, all others should be rigidly ex- 
cluded. The husband may also form an exception to this rule, 
provided he is not a so-called "overgrown baby," but is manly and 
energetic, and at the same time loving and tender. 

The sick chamber for such occasion should be a model of neatness 
and simplicity. Especially should all upholstered furniture be excluded 
and thick inside curtains, as these articles are only repositories of 
dust, dirt and fferms for disease. In the first week of confinement 
and perhaps a day or so before, the room should be slightly darkened, 
but under this must not be also understood the exclusion of fresh pure 
air. Judicious ventilation is of the utmost necessity, and also a little 
disinfectant in the shape of dissolved blue vitriol, placed in vessels 
about the room is highly recommendable. Upon entering a room 
where confinement has taken place, it should not be recognizeable by 
the odor, which one finds occasionally in apartments of this kind, or 
nurseries. The room should not be swept with a broom nor dusted, 
but be cleaned by means of dampened mop and cloths. 

The bed of the young mother should be approachable from three 
sides. In winter not too close to the stove and in summer in not too 
close proximity to any window. It should consist of a spring 
mattress, a good horsehair or chuck mattress, and an oil cloth or 
rubber sheet, and covered with the usual sheets and blankets. You 
should also be careful to have in the room wash basin towels, clean 
hot and cold water, Carbolic Acid, 10% C. P., Bottle No. 5, Vaseline, 
Bottle No. 14. Also a fountain syringe, for the purpose of irrigating 
the sexual organ after birth ; and in case of necessity to give an in- 
jection to mother in order to clean out the rectum. The bed pan 
should also be in the room. 

No body should be allowed to come in contact with the young 
mother, to help her to stool or other necessary aid unless they wash 
their hands thoroughly, using a nail brush, and soap, and after wip- 
ing dry, rub a little carbolic acid 10% C. P., Bottle No. 5, on their 
hands. Physicians and midwifes will always do this. 

Delivery and directions for care of mother and child should be left 
to the physician or midwife, and the period of confinement should be 
superintended by an experienced nurse. These directions must be 
guided by circumstances, which, of course cannot be generalized 

The following hints may be of service to the unexperienced, as to 
the mode of life they should pursue during pregnancy. 



— 



DIET AND CARE. 295 

The diet should be simple, nutritious and easy of digestion, the 
food should be thoroughly mastricated and very little cold drink 
should be taken during meal times. Pregnant women do not require 
much additional food, and large quantities, especially of rich dishes 
are entirely out of place. Stimulants partaken during pregnancy are 
hurtful, to both mother and child. 

Common sense should teach every woman, who is in an interesting 
condition, to leave off lacing any way to such extent, as to suppress 
her portruding abdomen. 

In order to retain good health during pregnancy, and to facilitate 
delivery, it is necessary that women in this condition should exercise 
by walking in the open air, every day, if the weather is favorable. 
This exercise shoule, however, be not to such extent, as to cause 
fatigue. If possible the walk should be taken in the morning. 
Carriage rides do not insure the movement and exercise of joints and 
muscles, as walking does, and, if taken on a rough road, in a vehicle 
with poor springs, often causes such shaking up as to result in evil 
consequences. All great mental exertions, emotions, grief, anger, 
despondency, as well as excessive physical labor, must be strictly 
avoided. Especially the latter should be specially guarded against 
as it takes much of the vitality of the body, which, towards the critical 
moment, must be husbanded, as all the strength is needed to give 
life to the little one. Many a good woman, while endeavoring to 
have everything in the best of order before her confinement, has over- 
taxed herself, and thereby wasted that strength she needed so much 
in the hour of delivery. The drain upon her vitality during the 
period of gestation, and that caused by the house work, she considered 
so necessary, exhausted her physical resources, and wasted, as contra- 
indicated by nature. Every woman must abide by the laws of nature, 
in such cases, even if they are not suitable to her. Any transgres- 
sions are severely punished and with it, grief is brought to the whole 
household and friends. 

Ladies in an interesting condition, not taking the necessary health- 
ful exercise, or eat such food, which is not easy of digestion, will 
invariably suffer from constipation towards the latter period of gesta- 
tion. The rectum in such state should be regularly evacuated, espaci- 
ally on days immediately preceding confinement. If it cannot be 
effected by the diet, light injections of luke warm water should be 
resorted to. As remarked in preceding chapter, the physician or mid- 
wife should be called as soon as the first symptoms of labor make 



296 BIRTH. 

their appearance. Should, however, through some unforseen causes, 
the doctor or midwife fail to make their appearance and birth takes 
place before the arrival of either one, a nurse or friend of the family 
is usually around. In such cases we can only counsel to be calm, 
self-possessed and thoughtful and observe the following points, and if 
they are observed the safety and comfort of the patient is assured, at 
least, until such time as professional aid arrives. 

For instance, if the head of the baby be first born, as is nearly 
always the case, that being the most advantageous position, and the 
face becomes darkened, it is a sign that the little one is in danger of 
suffocation. Assist by inserting your index finger under the armpits 
of the baby and by gently prying, assist thus in the delivery. Under 
no circumstances should the head be pulled, as such procedure is ac- 
companied by dislocation of the neck. If the little body has appeared 
as far as breast, the remainder of the exit should not be facilitated. 
Nature after that will help itself. 

As soon as the child is born, the nurse should at once remove it out 
of the wav of the mother's discharges, place it where it has room to 
breath, and see that its mouth or nostrils is not covered. These 
orifices should also at once be inspected, and if any mus be found 
therein, it is to be removed. Further attention is directed, as to 
whether the navel string be tight around the child's neck, if so, 
uncord it at once in the most gentle manner in order to prevent 
strangulation. 

To tie the navel or umbilical cord, take a strong pidce of cotton or 
flax twine, which has first been saturated in carbolic acid 10% C. P., 
Bottle No. 5, using half pure water, and tie firmly by a double knot 
around the cord, about two inches from the body of the infant; two or 
three inches further from the body of the child apply a similar ligature, 
and cut between these two ligatures with a pair of blunt pointed 
scissors the umbilical cord. Especial attention is invited to the 
necessity of ascertaining whether the child has given the proper signs 
of life, before the navel cord is either tied or cut. Life manifests itself 
usually by breathing or crying and experienced women seldom make 
a mistake as to this. 

The umbilical cord having been properly ligatured and divided, the 
baby should be washed in luke warm water and be properly dressed. 
No attempt should be made to pull at, or otherwise endeavor to re- 
move the after-birth cailed placenta. The only permissible facilitation 



AFTER BIRTH. 297 

of expulsion of the after-birth is gentle downward rubbing on the 
the abdomen over the approximate region of the womb. This 
procedure has a tendency to contract the womb, by which detachment 
and expulsion of the after-birth is usually affected. Whether the 
placenta is detached or not, can be felt by touching the lower part of 
the abdomen. If upon such examination, the womb feels as if con- 
tracted like a rather hard round substance, it is evident that detach- 
ment has taken place. The surest diagnosis, as to whether the after- 
birth has losened, is made by taking hold of the protruding cord, and 
to gently, but firmly squeeze it. If pulsation is perceived, separation 
is not completed. Then gentle pressure on the lower abdomen should 
be resorted to again. As soon as pulsation stops entirely and the 
placenta is not expelled, it is lodged in the vagma. From there it 
can be removed by grasping by means of two fingers the placenta, 
immediately back of its insection and assisting in its expulsion, by 
steadily but evenly in a spiral or twisting movement. Under no 
circumstances should force be resorted to. The spiral or twisting 
movement winds the membrane into a sort of rope, which is not 
likely to be torn. The removal of the after birth is better attended 
to before the griping pains ensue. 

The first hour or two after the birth, the child should be kept as 
quiet as possible, and in case it sleeps, be left undisturbed. The 
mother likewise should not be disturbed and remain in the same 
position she was in during the birth. She should not be bothered 
with anything, save the removal of soiled napkins from her privates. 
Her position should be rendered as comfortable as possible and she should 
be not permitted to make the slightest exertions, as these are very apt to 
lead to haemorrhages. The tendency to these is much reduced after 
an hour or two> A cup of hot tea, or of strained oatmeal gruel, rather 
thin, may be given her. 

If from the exertions she has undergone, her heart's action or pulse 
is very feeble, a table spoonful of good old whiskey mixed with about 
two tablespoonfuls of water may be given, but it is better left to the 
discretion of the physician or nurse. Should the mother have a de- 
sire to urinate, soon after the labor, do not allow her to assume a 
sitting posture under any circumstances, but shove a bed pan or flat 
dish under her. 

If all persons except the nurse are excluded from the sick chamber, 
the utmost quiet is obtained, the room well ventilated, at a proper 
temperature, the young mother usually succeeds in obtaining shortly 



298 CAEE OF THE MOTHER. 

after the birth a nice little sleep of considerable duration, after which 
her exhausted energies become soon renewed. And if so, should no 
threatening symptoms forbid, the mother may be made comfortable 
and be placed in a clean and comfortable bed, or the one she occupies 
be fixed up with fresh linens, from whioh all dampness has been 
thoroughly abstracted. We remind the attendants again, that even 
during this process, the patient must not change her horizontal posi- 
tion. As soon therafter as practicable, the nicely washed and dressed 
baby should be installed at the mother's breast, then to receive its 
daily bread for some time to come. By being relieved of some of the 
milk by her child has a tendency to contract the womb, by which 
further danger of haemorrhages are greatly reduced. The attendant 
should often examine the napkins, and ascertain if there is any undue 
bleeding. If such is the case, the directions of the attending physician 
should be strictly followed. 

From the time labor has been completed, the mother and child 
made comfortable, no one should remain in the room, but the nurse, 
and the mother be induced to sleep, nature's best restorative. 

The treatment of diseases arising from and during the labor of 
childbirth, cannot be generalized, inasmuch as they depend upon too 
many different circumstances, and should be left to the care of the 
attending physician. The learned man will notice symptoms, which 
the uneducated eye fails to detect and in the majority of cases, give 
counteracting remedies which stop the disease in its infancy. By 
such means he even avoids anxiety and fear in the patient, which is 
an aid to an earlier convalescence. 

The diet during time immediately succeeding delivery, should be 
one of a very nourishing nature and at the same time easy of digestion. 
Within twenty-four hours after delivery, a nicely broiled mutton chop, 
or the breast of a spring chicken, with dry buttered toaste, (cold) and 
a cup of black tea, may already be given. Oatmeal gruel, porridge of 
farina or arrow root, light farinaceous puddings and such like can be 
given for breakfast and supper in addition to the usual cup of tea and 
toast. Fruit and everything of an acid nature must be avoided for a 
considerable length of time, excepting perhaps dried apples or peaches, 
thoroughly stewed and sweetened. 

An exclusive diet, during the period of confinement, of soups, gruels, 
porridges and similar articles, are only a relic of the past and should 
not be adhered to. The urgent advice of the good and wise old ladies, 



MISCARRIAGE. 299 

to the contrary, notwithstanding, such diet has a tendency to distend 
the stomach, cause constipation and retard the healing processes. 

Miscarriage, is the expulsion of the foetus, in the early months of 
pregnancy and hefore it is able to sustain life. 

The causes for this unfortunate occurrence are a multitude ; weak 
constitution, profuse menstruation, cramps in the womb, excessive 
and too energetic sexual intercourse during pregnancy, diseases of the 
womb and abdomen, late hours, overreaching as is often done in 
hanging curtains or pictures ; falls on slippery floor or pavement, too 
much stair climbing or taking a false step ; riding in vehicles without 
springs or on a rough road ; dancing, tight lacing, too much work on 
sewing machine, diorrhoea, care, anger, grief, fright, or violent 
mental emotions. 

Miscarriages usually happen to women, who lay themselves liable 
to above enumerated causes, and those who do not take any kind of 
gentle muscular exercise. When once it has happened to a lady, a 
predisposition is established and is very liable to occur again, unless 
the exciting causes are rigidly obviated. 

As soon as a lady is positive that she is in state of pregnancy and 
feels indisposed to exertion, languid and in a similar manner as if the 
menses were about to return, she may consider herself liable to have 
a miscarriage. Are the symptoms more manifest by discharge of 
blood, cutting pain in loins and abdomen, recurring in fits, and in- 
creasing in intensity, she is threatened already with a miscarriage. 
The immediate symptoms, prior to the expulsion of the fetus, are 
slight pains gradually increasing, and recurring with much severity, 
bearing down of the womb, watery discharge and delivery of the fetus. 

When the foregoing symptoms arise, quite rest is necessary, upon a 
hair or other mattress, in a horizontal posture, for a day or two, after 
that avoid any of the named causes. At the time the monthly period 
should occur, keep very quiet and avoid all sorts of excitement, both 
mental and physical. It is evident, that ladies with symptoms 
showing tendency towards miscarriage, must not grant any request 
from her husband. It is better that they do not sleep in the same 
bed. Temptation is too great. Let the husband show his manliness 
by controlling his passions by will-power, and in case that is insuffici- 
ent, let him apply cold compresses to his private parts. 

If miscarriage actually has taken place, the care and treatment is 
identical with that in case of childbirth. Husband and wife must 
after this occupy different rooms for at least two months. 



Index, 



Abdominal enlargement, . . . 293 

Absorbents, 6 

Absorbing vessels, 3 

Age and. sex 41 

Alcoholism, 137 

Almond Milk, 82 

Alimentary canal, 11, 13 

Anaemia Ill 

Animal heat, 30 

Aorta, 4 

Aphasia, 137 

Apoplexy, 113 

Appendix Vermiformis, 14 

Appetite, 49 

Apple drink, 82 

Arteries, 4 

Arteries, coats of, 5 

Arteries systemic, 4 

Arteries, where found, 4 

Articular inflammation, . . . .240 

Asthma, 185 

Auricles of heart, 16 

Awake and asleep, 47 

Axis, 7 



Barbers Itch, 62, 263 

Bed clothing, 86 

Bed sores, 69 

Bed wetting, 215 

Bile, 25 

Bile fever, 162 

Birth, 293 

Bleeding at Nose, 172 

Bleeding from Bronchi, 193 

Bleeding from lungs, 193 

Bleeding from kidneys, 212 

Bleeding from wounds, v . . . 284 

Blood, 21, 54 

Blood, quantity in body, ... 21 

Blood swelling ear, 97 

Blood vessels, , 3 

Bloodshot eyes, 95 

Bloody flux, 273 

Body, the human, 1 

Boils, 289 

Bones, 64 

Bones in skeleton 1 

Bones, names of 1 

Bone softening 246 



INDEX. 



301 



Brain, 7 

Brain, formation of 70 

Breathing 51 

Bread 84 

Bread, liquid 82 

Breasts 20 

Brights disease, acute 212 

Brights disease, chronic 213 

Bronchus 17 

Bronchitis 44, 183 

Bunions and corns 62 

Bruises 64 

Burns and scalds 287 

Buzzing in ear 98 

Caecum 14 

Caecal valves 14 

Capillaries, 5 

Cappillaries, size of 5 

Canal, alimentary 11 

Canal semi-circular 10 

Cancer, liver 167 

Cancer, kidney 214 

Cancer, stomach 152 

Carbuncles 63, 289 

Care of sick 87 

Cartilages 2 

Catalepsy 74 

Catarrh, acute 187 

Catarrh, bladder 214 

Catarrh, ear 98 

Catarrh, eyes 94 

Catarrh, larynx 174 

Catarrh, nose 177 

Catarrh, stomach 145 



Catarrh, vagina 213 

Cause of sickness 42 

Cerebrum 8 

Circulation 28 

Circulation of blood 54 

Circulation, mechanism 29 

Change of life 230 

Chapped face 238 

Chapped hands 238 

Chest, cavity of 16 

Chicken pox , 256 

Chlorosis 277 

Cholera 271 

Cholera infantum 149 

Cholera morbus 147 

Choroid coat, eye 10 

Chronic rheumatism 240 

Chronic nasal catarrh 171 

Chylification 24 

Chymification 24 

Clap 216 

Clitoris 19 

Clothing 38 

Closures womb 224 

Cochlea 10 

Colds 35 

Cold in bead 177 

Cold, what is a 34 

Colic in intestines 158 

Colon 15 

Common duct 15 

Complaints of sick 41 

Congestive veins 210 

Congestion or liver 165 



302 



INDEX. 



Constitution 41 

Constipation 156 

Consumption 200 

Consumption spinal cord. . .116 

Contusion 65 

Convulsions in infants 130 

Contractions womb 224 

Contractions air tubes 192 

Cornea 10 

Corns and bunions 62 

Cough 53 

Cramps in larynx 181 

Cramps in muscles 120 

Cramps in stomach 144 

Croup 142, 178 

Cystic duct 15 

Darkening of the nipples . . .292 

Daafness , 99 

Death 69 

Diarrhoea 155 

Deglutition 23 

Delirium 107 

Diabetes 281 

Diet, sick 77 

Digestion 11,22,36 

Digestion stomachial 24 

Digestion intestinal, small. . 24 
Digestion intestinal, large . . 27 

Diptheritis 265 

Discharge of pus from ear . . 98 
Dislocation of joints. . . .65, 288 

Disinfection 90 

Disease, general signs of . . . 48 
Diseases of brain 71, 105 



Diseases of blood 55 

Diseases of cornea 96 

Diseases of ear 73 

Diseases of eye 72 

Diseases of excretary organs 58 

Diseases of larynx 52 

Diseases of lymphatics .... 57 

Diseases of muscles 64 

Diseases of nerves 66 

Dreams 136 

Dropsy of the chest 207 

Duodenum .... 13 

Dyspepsia 153 

Dysentery 273 

Ear 9, 10 

Ear, its care 96 

Ear wax 97 

Eczema 62, 235 

Effect of medicines 91 

Eggs 84 

Enlargement of breast .... 292 

Enlargement of heart 207 

Epilepsy 127 

Erysypelas 233 

Eye 72 

Eyelids, cramps in 94 

Eye, globe of 10 

Eye, its care 92 

Expiration 30 

Fainting.. 290 

Falling of the womb 224 

Far sightedness 72 

Fascia 3 

Fatty degeneration of heart. 209 



INDEX. 



303 



Fatty liver 166 

Felon 63 

Female generative organs . . 19 

Fever, origin of 46 

Fistula 63 

Flickering before eyes 96 

Foreign substances in eyes . . 95 
Foreign substances in ear . . 97 

Fractures 288 

Fractures of Bones 65 

Freckles 289 

Frostbites 286 

Fruit lemonade , . . . 83 

Fruit water 82 

Functions of relation 31 

Gallbladder 15 

Gallstones 168 

Ganglia 7 

Gastric catarrh 148 

Gastric fever 162 

Glands, salivary 13 

Glands, tracheal 17 

Gonorrhoea 216 

Gout... 241 

Granulation of wounds 63 

Giowth in larynx 180 

Growth of skin 235 

Gullet 13 

Gumboil 289 

Gymnastics 90 

Habits 42 

Hallucinations 108 

Haemorrhoids , 157 

Health, what constitutes it . . 40 



Healing of wounds 63 

Hearing 9 

Heart 16 

Heart, auricles of 16 

Heart, ventricles of 16 

Herpes ...234 

Houses 38 

Humming in ear 98 

Hydrophobia 276 

Hypochondria 134 

Hypermetropia 72 

Hyperaemia 105 

Hymen 19 

Hysteria 131 

Idiocy 136 

Ileum 13 

Impotence 219 

Inflammation 43 

Inflammation, joints 66 

Inflammation, lungs 195 

Inflammation, lid glands eye 94 

Inflammation, mouth 139 

Inflammation, ovary 211 

Inflammation, skin 232 

Inflammation, liver 165 

Inflammation, womb 223 

Inosculation of arteries 4 

Insalivation 23 

Insanity 136 

Inspiration 30 

Intestinal catarrh 155 

Intestine, large 14 

Intestine, small 13 

Iris 10 



304 



INDEX. 



Irritable breast 103 

Itch 62,237 

Itching, private parts 289 

Jaundice 167 

Jejunum 13 

Joints 2 

Kidneys 18,37 

Labor 294 

Labyrinth 10 

Lacteal vessels 6 

Laryngeal consumption .... 180 

Laws of nature 39 

Lemonade 82 

Leucorrhoea 222 

Ligaments 3 

Light 38 

Lips 11 

Liver 5, 15, 37 

Liver duct 15 

Lobes of lungs 17 

Lock jaw 125 

Lumbago 64, 103 

Lungs 16, 17, 37 

Lying in chamber 294 

Lymphatics 6, 33 

Male generative organs 18 

Mammary glands 20 

Mania 136 

Malarial fever 267 

Mastication 23 

Meals for sick 85 

Measles 62, 247 

Medicine, administration of 89 
Medulla oblongata 7 



Melancholia 136 

Menningitis 115 

Menstruation . . 225 

Menstruation, painful 228 

Menstruation, profuse 230 

Menstruation, premature. . .227 
Menstruation, tardy . . t . . . 227 

Mesenteria 14 

Migranis 101 

Miscarriage 299 

Monotony in voice 137 

Morning sickness 292 

Mouth 11 

Mouth cankers 138 

Motherhood 49, 50 

Muscles 2 

Muscles, names of 3 

Muscular rheumatism . . 64, 241 

Mumps 140 

Myopia 72 

Names of bones . 1 

Names of Musles 3 

Nasal catarrh 171 

Nasal diseases 52 

Near sighted 72 

Neuralgia 100 

Neuralgia, chest 102 

Neuralgia, face 102 

Nerves 33 

Nerves, classification 8 

Nerve matter 33 

Nerves, sympathetic 9 

Nettle rash 234 

Nurses, who are best 76 



INDEX. 



305 



Nursing 80 

Nursing, general rule 75 

Nutrition 22 

Nutriment, change in 45 

Oatmeal * 81 

Occupation 38, 86 

Oesophagus 13 

Organs of digestion 11 

Organs of nutrition 49 

Organs of respiration 17 

Organs of sense 9 

Organs of urination 18 

Organs of voice 17 

Ova (egg) 20 

Ovaries 20 

Oviducts 20 

Ovarian tumors 222 

Pain in ear 98 

Pain in stomach 144 

Palate 12 

Palpitation of heart 208 

Pancreas 15 

Pancreatic juice 25 

Paralysis or palsy 121 

Paralysis vocal chords 182 

Parotid glands 13 

Parotitis 140 

Penis 18 

Pen palsy 119 

Pericardium 116 

Periosteum , 1 

Peritoneum 15 

Peritonitis 163 

Perspiration 60 



Perspiring feet 238 

Perspiring hands 238 

Pharynx 13 

Pharyngitis 142 

Phlegm 53 

Physician 40 

Pies, etc 84 

Piles 157 

Pleura 16 

Pleurisy 206 

Pneumonia 195 

Pneumonia, catarrhal 191 

Podogra 241 

Pollutions 219 

Polyps in nose 172. 

Portal vein 5 

Pregnancy 291 

Prehension of food 22. 

Progressive palsy 122 

Proud flesh 289 

Pupil of eye 10 

Pulmonary consumption 200 

Pulmonary artery 4 

Pulmonary vein 5 

Pulse !.. 29 

Psoriasis . 235 

Quickening 293 

Raw beef 84 

Regulations, dietary 79 

Regulating stool 88 

Reproduction 291 

Respiration 17, 30 

Respiration and circulation . 68 
Respiratory movements 53- 



306 



INDEX. 



Respiratory organs 50 

Rheumatism 238 

Rheumatism, chronic 240 

Rheumatism, muscular .... 241 

Rheumatism, joint 238 

Rickets 243 

Ringworm .... 234 

Rush of blood to brain 105 

Salivary glands 13 

Salivation 141 

Salt rheum 235 

Scabies 237 

Scalds and burns 287 

Scarlet fever 62, 250 

Scrofula 279 

Scrotum 19 

Sciatica 103 

Scurvy 139 

Semen 19 

Sense, organs of 9 

Shocks 287 

Sickness, cause of 34 

Signs of consumption 201 

Signs of sickness 41 

Sigmoid flexure 15 

Sight 10 

Sick chamber 85 

Sickbed 86 

Sick headache 101 

Skin 9, 37 

Skeleton ...... 1 

Sheep pox 256 

Smallpox , ...253 

Smell 9 



Sneezing 51 

Sore nipples 238 

Sore throat 141, 177 

Soul 33 

Sores on anus 163 

Soups 83 

Sonambulism 163 

Spasms of face 118 

Spasms of stomach 153 

Spasms of larynx 181 

Spinal cord 7 

Sprains 288 

Spleen 15 

Squinting 94 

Strengthening drink 82 

Stomach 13, 24 

Stomach, overloading 143 

Stones in bladder 215 

Stool 70 

Stomach cramps 144 

Sty on eye 93 

Stottering 137 

St. Vitus Dance 122 

Starvation 46 

Suppressed menses 228 

Sublingal glands 13 

Submaxillary gland 13 

Swallowing 23 

Swelling of eyelids 93 

Swoons 290 

Sycosis 236 

Syphilis 62, 180,275 

Syphiloma, liver 166 

System, nervous 7 



INDEX. 



807 



Tailors' muscle 3 

Teeth 12 

Temperature of body 46 

Temperature of blood 21 

Tendons , .... 2 

Testes 19 

Thoracic duct 6, 7 

Thorax 16 

Trachea 17 

Toothache 138 

Touch. 9 

Trichinosis 275 

Tuberculosis 200 

Tumors womb , . . . . 225 

Typhoid fever 62, 259 

Typhus fever 256 

Tying the cord 296 

Tympanum 73 

Ulcers, intestine 156 

Ulcers, stomach 151 

Urine.. 18, 59,70 

Urinary organs 17 

Urination 27 

Uterus 20 



Vagina 20 

Vegetables 84 

Veins 5 

Ventilation 38 

Ventricles of heart 16 

Vestibule 10 

Villi 14 

Villi, intestinal 26 

Voice 17 

Warts 238 

Water pox 256 

Washing the sick '. . 86 

What ails the sick 41 

Whitlow 63 

Whites 222 

Whooping cough 187 

Wind pox 256 

Windpipe 17 

Wines, medicinal 87 

Womb 20 

Worms 159 

Wounds in skin 63 

Wounds, general 284 



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